non-compliance, denials and/or penalties to the patient, hospital and physician(s). Initiates notifications to insurances...
that do not require acute care services, as appropriate. Refers to A Physician Advisor for denials and cases that do not meet medical...
claims with the appropriate payer. ● Research appeal and resolve claim rejections, underpayments, and denials with payers...
-authorizations with third-party payers to minimize authorization related denials through phone calls, emails, faxes, and payer... rejections and/or denials. Maintains a current and thorough knowledge of utilizing online eligibility pre-certification tools...
, rejections and/or denials to ensure appropriate payer reimbursement · Handles calls and questions from patients, physicians...
and validation Investigate and problem solve insurance denials on a monthly basis in order to recover lost revenue...
non-compliance, denials and/or penalties to the patient, hospital and physician(s). Initiates notifications to insurances...
: Review, identify and resolve claim denials Prepare and submit appeals for denied claims, monitor and track results Provide... requested additional information to facilitate claim processing Monitor denials by reason, provider and payer Resolve...
and provider documentation. Following review of overpayment or underpayment denials, provide appropriate follow-up to coding team...
. 9. Assists Patient Access and Care Management with denials investigation and resolution. 10. Participates...
unpaid claims within standard billing cycle timeframe Timely review/handling of insurance claim denials, exceptions... and bill secondary or tertiary Documenting denials associated with patient responsibility to forward to the collection team...
integrity issues. Responsible for completion of appropriate error/issues in Work Queues. Identifies and resolves Payor Denials...
diagnosis, procedure details or authorizations and information for denials as needed. Uses medical terminology and scheduling... verification, notification, and authorization functions, follow ups on denials and no response claims. Communicates...
non-compliance, denials and/or penalties to the patient, hospital and physician(s). Initiates notifications to insurances...
, billing, payments and denials. Comprehensive knowledge of patient insurance process for obtaining authorizations and benefits...
regulations. Responsible for processing Coding Claim Denials and Coding Claim Rejections, when applicable Licensure...
multiple facets of patient account coordination including insurance/benefit verification, denials management, and collections...
, emergency department utilization, and denials management in facilitating appropriate utilization of hospital resources...
downgrade denials related to coding and clinical determination to support appeal strategy, tracking by disease, payer and denial... activity and works with teams to create transparency and improvements to mitigate and prevent denials. Clearly communicates...