- TEKsystems (Annapolis, MD)
- This is a hybrid position in Annapolis, MD Description Position Summary The clinical denial appeals specialist is responsible for the identification, ... medical necessity, responding to authorization concerns, and/or reconciling coverage-related issues. The clinical denial appeals specialist also works… more
- CaroMont Health (Gastonia, NC)
- …and DRG Denial Management and Appeals based on departmental needs. The Clinical Documentation and Denial Specialist is responsible for assisting the ... Job Summary: The Clinical Documentation and Denial Specialist...determine if an appeal is warranted. Where warranted, the Appeals Specialist will write sound, compelling factual… more
- Baptist Memorial (Memphis, TN)
- Summary The Denial Mitigation Specialist - Denial Escalation Quality Assurance evaluates the adequacy and effectiveness of internal and operational controls ... including federal and state regulations and guidelines. The Quality Assurance Specialist will be responsible for analyzing and interpreting trends associated with… more
- Molina Healthcare (Tampa, FL)
- **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and correct clinical decisions for appeals outcomes within ... compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical /medical reviews of previously denied cases in which… more
- University of Michigan (Ann Arbor, MI)
- …Supervisor - Appeals & Denials Apply Now **Job Summary** The Denial Coding Supervisor provides subject matter expertise in physician medical coding, insurance ... billing, and follow-up activities. This position oversees the Physician Billing (PB) Denial Coders and Appeals and Denial Coordinators, ensuring the accuracy… more
- Genesis Healthcare (Seven Fields, PA)
- …with our Clinicians in Action professional development program. Responsibilities The Denials and Appeals Specialist is responsible for the follow up of denied ... Part-Time team members. + **Support for New Grads & Clinical Fellows:** Our Powerback Clinical Mentorship Program...response from the payer and takes appropriate action, including appeals , based on the type of denial .… more
- Rush University Medical Center (Chicago, IL)
- …denials, documents appeals for clinical inpatient denials, conducts appeals as appropriate. Track denial outcomes, identify trends and work ... by the Care Management Department and Rush University Medical Center. 9. Coordinates clinical appeals process and participates in in compliance investigations as… more
- Hartford HealthCare (Farmington, CT)
- …research and works with others as needed to determine the appropriate course of denial appeals . * Collaborates with clinical staff and/or outside providers ... common practices across the system. *_JOB SUMMARY_* The Denials Specialist 1 is responsible for HIM Coding denial...further information to be used in the coding and appeals process. * Creates written appeals utilizing… more
- Houston Methodist (Houston, TX)
- …for coordinating and monitoring the coding-specific clinical charges and denial management and appeals process in a collaborative environment with ... revenue cycle management and clinical partners at various Houston Methodist facilities. This position...current procedural terminology (CPT)/healthcare common procedure coding system (HCPCS), denial reasons, and appeals . Monitors recovery of… more
- AdventHealth (Altamonte Springs, FL)
- …denial root cause and bring about the best opportunity for fair reimbursement. The Clinical Denial Management Specialist will adhere to the AHS Compliance ... obtain further patient information to be used in the appeals process if necessary. . Provide reports, education, and...necessary. . Provide reports, education, and training on identified clinical denial trends and recommended remediation as… more