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Lifepoint Health
Overview
Facilitates clinical reviews for patient admissions and continued stays to determine the legitimacy of treatment and length of stay. Interfaces with managed care organizations and payers to secure insurance coverage and advocate for necessary patient treatment.
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Compensation
$33 - $45 / HOUR
Posted
3 days ago
UF Health
This role serves as an enterprise-level denial management coding analyst focused on reducing denials, improving reimbursement, and maintaining high coding standards across the organization. Responsibilities include leading projects to enhance coding effectiveness and appeal turnaround times while educating departments on compliant practices.
Salary not listed
12 days ago
Guthrie
Coordinates with clinical staff and insurance companies to obtain authorizations for home health and hospice admissions. Manages insurance documentation, notifies case management of interactions, and handles potential denials.
$17 - $26 / HOUR
29 days ago
Crossing Rivers Health
The Medical Coding and Prior Authorization Specialist is responsible for coding patient encounters and managing prior authorization processes. This role ensures compliance, maximizes reimbursement, and facilitates timely access to necessary medical care for patients.
1 month ago
Independence Health System
The Case Manager is responsible for conducting utilization reviews, managing patient care plans, and facilitating appropriate discharge planning in collaboration with the healthcare team. They also handle denial management, educate staff on managed care standards, and ensure accurate documentation of patient resource utilization.
UHS
The Utilization Management Coordinator monitors cases for medical necessity and manages the admission and continued stay review process with managed care companies. They also collaborate with the medical staff and treatment team to identify documentation defects and participate in efforts to recover reimbursement denials.
Wolcott, Wood and Taylor Inc.
The PB Coder reviews and analyzes ambulatory and hospital-based encounters to assign accurate CPT, ICD-10, and HCPCS codes. They also collaborate with providers to ensure documentation accuracy and resolve coding denials to maintain compliance with reimbursement policies.
Northwestern Memorial Healthcare
The specialist reviews medical records to abstract and assign appropriate CPT, ICD-10, and HCPCS codes for professional services, focusing on complex encounters like anesthesia and surgical procedures, aiming for a minimum of 95% accuracy. This role also involves training providers on documentation, resolving coding edits, reconciling charges, and collaborating with operational areas to address claim issues and denials.
$26 - $36 / HOUR
2 months ago
Heart and Vascular Care Inc
The specialist is responsible for obtaining complete and accurate insurance information, verifying benefits, and accurately interpreting benefit plans to ensure proper authorization for procedures. Duties also include explaining financial responsibilities to patients and maintaining accurate documentation of authorizations and related information.
Samaritan
The specialist coordinates and secures prior authorizations for hospital and clinic services, manages outgoing referrals, and ensures compliance with payer requirements to support patient care and reimbursement. This role acts as a liaison between providers, patients, payers, and internal departments to minimize care delays and documentation errors.
$44,179 - $59,987 / YEAR
The specialist coordinates and secures prior authorizations for hospital and clinic services, manages outgoing referrals, and ensures compliance with payer requirements to support patient care and reimbursement. This role acts as a liaison between providers, patients, payers, and internal departments to minimize denials and care delays.
Your Behavioral Health
The Utilization Review Coordinator is responsible for securing initial and concurrent insurance authorizations for various levels of care including Detox, Residential, PHP, and IOP, as well as TMS services. This role involves conducting clinical reviews and advocating with commercial health plans to ensure medically necessary care is approved.
$21 - $26 / HOUR
Tucson Dermatology, Ltd.
The specialist will manage key revenue cycle functions including ensuring coding accuracy, processing claims, handling payer credentialing, managing denials, and overseeing provider enrollment. This role involves close collaboration with clinical and administrative teams to maintain accurate billing and efficient reimbursement processes.
The Pennant Group
The coordinator will oversee all aspects of payer authorization, including the timely submission and tracking of initial requests, managing 485 and add-on authorizations, and monitoring ongoing patient eligibility.
CrewBloom
The Medical Biller is responsible for accurately and efficiently processing medical claims and invoices to ensure timely reimbursement from insurance companies and patients. This involves preparing claims, generating invoices, verifying insurance, assigning medical codes, posting payments, and managing denials.
3 months ago
The Medical Biller is responsible for accurately and efficiently processing medical claims and invoices to ensure timely reimbursement from insurance companies and patients. Key duties include preparing claims, generating patient invoices, verifying insurance coverage, assigning medical codes, posting payments, and managing claim denials.
The Medical Biller is responsible for accurately and efficiently processing medical claims and invoices to ensure timely reimbursement from insurance companies and patients. This involves preparing claims, generating patient invoices, verifying insurance, assigning medical codes (ICD-10, CPT, HCPCS), and managing payment posting and denial appeals.
The Medical Biller is responsible for accurately and efficiently processing medical claims and invoices to ensure timely reimbursement from insurance companies and patients. Key duties include preparing claims, verifying insurance, assigning medical codes, posting payments, managing denials, and communicating with patients regarding billing inquiries.
Gateway Regional Medical Center
The EKG Tech prepares patients and assists cardiologists during cardiac stress testing, monitoring the patient's condition before, during, and after the procedure. Responsibilities also include applying holter monitors, managing related data transmission, assisting with report processing, and performing routine EKG testing as required by the facility.
Pain Control of Texas PLLC
This role manages insurance denials and payer disputes from identification through resolution, focusing on ensuring accurate reimbursement for services rendered. Key duties include reviewing, analyzing, and resolving claim denials, and preparing and submitting first-level and escalated appeals to various payers.
