- HCA Healthcare (Nashville, TN)
- **Description** **Introduction** Do you have the career opportunities as a Clinical Denials Coding Review Specialist you want with your current employer? ... are a committed, caring group of colleagues. Do you want to work as a Clinical Denials Coding Review Specialist where your passion for creating positive… more
- Houston Methodist (Houston, TX)
- … staff; and functions as clinical subject matter expert related to coding denials and appeals. **PEOPLE ESSENTIAL FUNCTIONS** + Communicates openly in a ... At Houston Methodist, the Coding Charges & Denials Specialist is...payers to successfully clear front end claim edits, appeal clinical denials , and address customer service inquiries.… more
- St. Luke's University Health Network (Allentown, PA)
- …who ensures clean claim submission and timely review and resolution of coding related claim denials for professional services, FQHC, MSO, and ASCs across ... coding , compliance, and documentation guidelines + Resolve Charge Review and Claim Edit CCI/LCD edits, diagnosis coding...and MUE frequency for clean claim submission + Resolve coding denials through claim correction or appeal.… more
- Kaleida Health (Buffalo, NY)
- **Director Clinical and DRG Denials ** **Location:** Larkin Bldg @ Exchange Street Location of Job: US:NY:Buffalo Work Type: Full-Time **Shift:** Shift 1 Job ... Description **Summary:** The Director, Clinical & DRG Denials provides ...managed care practices including but not limited to: utilization review , RAC, MAC, Q10, clinical and DRG… more
- WMCHealth (Hawthorne, NY)
- …Job Details: Job Summary: The Denials Manager's responsibilities include identifying all denials sent to APS Work queues and review and redistribute them ... redistribute to other departments for action/correction. + Conduct analysis on Clinical /Technical Denials and provide/recommend opportunities for improvement. +… more
- St. Luke's University Health Network (Allentown, PA)
- …and tracks outcomes regarding appeal process. Assists billing staff regarding outpatient denials for experimental, coding or other issues that may require ... clinically appropriate. + Investigates managed care and commercial insurance rejections, denials for possible experimental services and coding issues, providing… more
- BAYADA Home Health Care (Orlando, FL)
- …BAYADA Home Health Care has an immediate opening for a **Full Time,** OASIS and Coding Review Manager with OASIS and Coding certification to work remotely. ... match, direct deposit, and employee assistance program **Responsibilities:** + Review clinical information for appropriateness, congruency, and...MCM. + Prevent or decrease the occasion of Medicare denials by assuring proper coding on the… more
- BAYADA Home Health Care (Orlando, FL)
- …a full time OASIS Review and Coding Manager. The OASIS and Coding Review Manager provides support to all BAYADA Home Health Care Medicare service offices ... about BAYADA Benefits, click here (https://www.bayada.com/benefits/) . **Responsibilities:** + Review clinical information for appropriateness, congruency, and… more
- Independent Health (Buffalo, NY)
- …benefits and a culture that fosters growth, innovation and collaboration. **Overview** The Clinical & Coding Specialist-Senior will be responsible for reviewing ... coding and clinical decisions on cases involving complex clinical ...guidelines and financial policies/contracts. + Responsible for all reconsideration clinical appeals to include review of records,… more
- R1 RCM (Salt Lake City, UT)
- … clinical coders and coding team members who conduct a comprehensive review of coding denials and formulate appeals based on documentation and/or ... encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Coding Appeals Supervisor** , you will support… more