- Carle (Urbana, IL)
- Outpatient Denial / Appeals Specialist - RN + Department: Revenue Cycle - CFH_10_19 + Entity: Champaign-Urbana Service Area + Job Category: Clerical/Admin + ... clinical documentation review to establish and manage clinical and prior authorization denial appeals for the Carle enterprise. Represents Carle in clinical… more
- University of Utah (Salt Lake City, UT)
- …PRN39530B **Job Title** Outpatient /Provider Coder Level 3 **Working Title** Medical Appeals Coding Specialist SR **Job Grade** E **FLSA Code** Nonexempt ... documentation and coding. This position analyzes codes, charges and denial trends for complex or specialty services and will...-H), Certified Professional Coder-Payer ( CPC -P), Certified Coding Specialist ( CCS ), Certified Coding Specialist … more
- University of Washington (Seattle, WA)
- …follow up on appeals throughout entire process, determine next steps to ensure appeals either result in an overturned denial or have proceededas far as ... PATIENT FINANCIAL SERVICES Department** has an outstanding opportunity for a **CLINICAL APPEALS AND DISPUTES NURSE** **Work Schedule** + 100% FTE + 100% Remote… more
- The Mount Sinai Health System (New York, NY)
- …(NCO) for second level of appeal. Prepares concurrent review information for Review/ Appeals Nurses Meets timeframe for reviews/ appeals as specified by ... for the maintenance of accurate data for approvals, denials and appeals (in coordination with UM Manager and management). Prioritizes insurance Request/Denials… more
- The Mount Sinai Health System (New York, NY)
- **JOB DESCRIPTION** The Procedural Billing Specialist III is a senior level individual, responsible for multiple components of the billing process for specialized or ... Performs specialized coding services for complex or more specialized inpatient and outpatient medical office visits. Reviews physician coding and provides updates. +… more
- The Mount Sinai Health System (New York, NY)
- …Performs specialized coding services for complex or more specialized inpatient and outpatient medical office visits. Reviews physician coding and provides updates. + ... financial implications of out-of-network benefits, including pre-determination of benefits, appeals and/or pre-certification limitations. + Develops and manages fee… more
- Seattle Children's (WA)
- …creation of educational materials. Experience in revenue cycle functions, including coding denial management and appeals process. Experience in research of payer ... with the Revenue Integrity and Clinical staff in researching error patterns and denial issues and trends relating to facility coding accuracy. Coordinate the work of… more
- TEKsystems (Plano, TX)
- Required: + 2+ years of Insurance follow-up, denials/ appeals experience (Medical A/R) + Hospital/facility collections experience Description: Responsible for A/R, ... Responsible for managing CBO Aging Report properly to insure appeals are followed up timely to prevent past filing...timely to prevent past filing deadlines. * Communicates all denial write offs to Collection Supervisor, and Collections Manger.… more
- Huron Consulting Group (Chicago, IL)
- …are now and create your future. **Qualifications** The Utilization Management Specialist is responsible for ensuring the appropriate utilization of healthcare ... patient outcomes while managing healthcare costs. The Utilization Management Specialist ensures compliance with regulatory requirements and organizational policies.… more
- WellSpan Health (York, PA)
- …insurance claims, resolves claim edits, performs insurance account follow-up, researches claim denial for resolution and submits disputes and appeals . Represents ... to management, leadership, and insurance liaison.- Writes and submits appeals when needed to overturn claim denials.- Accesses external...within 1 year Required or + Certified Revenue Cycle Specialist within 1 year Required or + Certified Patient… more