payers, review EOB’s and medical policy to evaluate and submit for appeals, as well as perform in-depth research... and appeals based on payer guidelines in a timely manner Manages write-offs or adjustments on accounts when applicable, as well...
Surgery, Family Practice, Dermatology. JOB SUMMARY Utilizes clinical expertise, reviews insurance appeals, and prospective...
the clinical team Have exceptional leadership and communication skills, and a friendly personality Thrive on providing... Dental Experience preferred X-Ray Certification preferred CPR/First Aid Certified preferred If this all appeals...
on dental billing and accounts receivable for all payer types. Processing dental insurance EOBs, appeals, denials... One year of dental revenue cycle, dental billing, dental operations or dental clinical skills Knowledge of Eaglesoft, Open...
Clinical Coordinator to assist with grievances, appeals, and complaints from clients and oversight agencies of assigned clinics... on patient care needs, workflow, and other clinical needs. Identify, de-escalate, and solve patient concerns as they arise Work...
contracted programs and community partners. Manages the appeals process for Substantiated Child Maltreatment decisions... Certification Administrative Rules, Juvenile Justice Evidence Based Practice, and clinical intervention techniques. Ability...
in healthcare or related discipline o Additional experience in Medicare appeals, medical review, clinical, or other related... appeals, medical review, clinical, healthcare regulatory interpretation/application, healthcare compliance or related...
Financial Services (billing, insurance appeals, collections) procedures and policies Intermediate skill in Microsoft Office... our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare...
appeals, and potential quality of care concerns. Keep current with accepted standards and professional developments in the... areas of quality improvement and utilization management. Communicate and educate network providers regarding clinical...
Financial Services (billing, insurance appeals, collections) procedures and policies Intermediate skill in Microsoft Office... our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare...
applications and/or internet resources; obtains clinical information from physician offices and/or Bryan system; contacts BPN... Services regarding denials and appeals/reconsideration letters received from payers. 15. Maintains professional growth...
, CDM, Clinical Documentation, Coding, etc.) Performs extensive follow-up, completes appeals and makes referrals... with patients, as necessary, to obtain additional information. 5. Prepares necessary documentation to submit appeals to payers...
pertinent patient demographic and clinical information required to complete arrangements for post-acute care and/or placement.... - Supports and assists with concurrent insurance denials and appeals process. - Provides denial and non-certified day...
successful applicant will serve as an information resource and guide to our providers, clinical staff, practice managers, members of the... to medical diagnoses and clinical procedures, ensuring that medical billing conforms to legal and procedural requirements. The...
claims electronically and via mail. Follow up on outstanding insurance claims, appeals, and denials. Maintain up...-to-date knowledge of dental insurance policies and industry changes. Collaborate with the front desk and clinical teams to ensure...
Financial Services (billing, insurance appeals, collections) procedures and policies Intermediate skill in Microsoft Office... our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare...
: Oversee new client pre-delegation audits, annual client audits, development of grievance and appeals workflow processes... improvement opportunities. Oversee information presented to committees as directed, such as, the Quality Committee, Clinical...
: Utilizes clinical documentation to obtain prior authorization approvals and appeals. Assists patients with timely pharmacy...
Job Description Essential Functions: Collaborate with healthcare providers, clinical staff, and various departments throughout Monument Health... and clinical staff to communicate the need for pre-authorizations or referrals promptly, working to prevent delays in patient care...
, General Surgery, Family Practice, Dermatology. JOB SUMMARY Utilizes clinical expertise, reviews insurance appeals...