• Clinical Coding Appeals

    R1 RCM (Chicago, IL)
    …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Coding Appeals Supervisor ** , you ... well as reimbursement guidelines. **Here's what you will experience working as a Clinical Coding Appeals Supervisor :** + Track daily inventory of cases… more
    R1 RCM (02/15/25)
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  • Revenue Cycle Coding Supervisor

    University of Michigan (Ann Arbor, MI)
    Revenue Cycle Coding Supervisor - Appeals & Denials Apply Now **Job Summary** The Denial Coding Supervisor provides subject matter expertise in ... education initiatives + Ensures the collaboration required between the Clinical Documentation Specialists and Coding functions is...Detail** **Job Opening ID** 258393 **Working Title** Revenue Cycle Coding Supervisor - Appeals &… more
    University of Michigan (02/14/25)
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  • Health Plan Grievance and Appeals

    University of Utah Health (Salt Lake City, UT)
    …Supervise the day-to-day activities of staff who process member and provider Grievance and Appeals . + Monitor and set goals for staff workloads. + Ensure that staff ... are processing Grievances and Appeals efficiently and in compliance with applicable policies, regulations,...standards and overall patient experience. In addition to our clinical delivery system, we have a School of Medicine,… more
    University of Utah Health (01/28/25)
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  • Coding Spec-Clinic

    Covenant Health Inc. (Knoxville, TN)
    …procedures relative to coding . + Educates and assists physicians and clarifies coding versus clinical issues. + Works closely with Registration and Business ... Office personnel to resolve issues related to claims, coding , pre-cert, and denials appeals , and verifies that appropriate chargemaster rates are used. + Reviews… more
    Covenant Health Inc. (01/29/25)
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  • Senior Coding Specialist - (Telecommute…

    Houston Methodist (Houston, TX)
    …correct coding conventions to patient charge encounters in a clinical environment. This position abstracts diagnosis and procedural services from the physician ... growth and development and participation in team meetings. + Provides on-going coding and documentation education to physicians and clinical staff. +… more
    Houston Methodist (02/05/25)
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  • Claims Coding Analyst

    Healthfirst (FL)
    …ensure coding is consistent with the services billed and compares against the clinical coding guidelines in order to decide if a claim adjustment is ... policy requires. + Collaborates with other departments to improve compliance with coding conventions and clinical practice guidelines + Supports continuous… more
    Healthfirst (02/20/25)
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  • Clinical Denials Coordinator

    UNC Health Care (Goldsboro, NC)
    …all denials and is key point person for assigning team review. ie denials to Coding Supervisor . 4. Reviews and documents findings on all medical necessity and ... the Physician Advisors and subject matter experts for all audit and appeals work activities. Responsibilities: 1. Provides leadership, clinical expertise and… more
    UNC Health Care (12/06/24)
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  • Clinical Reviewer II (Special Investigation…

    Centene Corporation (Jefferson City, MO)
    …instructions to the claims department for prepayment reviews + Assist SIU Clinical Supervisor /Manager as needed with training new hires, answering questions ... erroneous practices + Consult investigators to identify abuse and fraud by utilizing clinical and coding expertise to analyze patterns in billing activities +… more
    Centene Corporation (02/23/25)
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  • Supervisor , Authorization Technician

    LA Care Health Plan (Los Angeles, CA)
    Supervisor , Authorization Technician Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... the safety net required to achieve that purpose. Job Summary The Supervisor , Authorization Technician supports the Utilization Management (UM) Specialist by handling… more
    LA Care Health Plan (01/25/25)
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  • Account Representative - (Museum District)

    Houston Methodist (Houston, TX)
    …appropriate billing functions, including claims resubmission to payors. + Creates and submits appeals when necessary. Engages the coding follow-up team for any ... medical necessity or coding related appeals . **GROWTH/INNOVATION ESSENTIAL FUNCTIONS** + Stays current on collection procedures of various payors and industry… more
    Houston Methodist (01/21/25)
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