to enhance efficiency. Monitor performance metrics, including productivity and accuracy, for all Clinical Denials & Appeals staff...
, Clinical Denials & Appeals). Hands-on experience with large EMR systems such as Cerner, Epic, or Meditech. Proven success...
-related denials and coordinate with billing and A/R teams to identify and resolve root causes. Stay current with documentation...
Denials & Appeals Nurse Specialist (IP & OP) , you will: Review denied claims, evaluate denial reasons, and carry out the...
and coding-related denials and coordinate with billing and A/R teams to identify and resolve root causes. Stay current...
Denials & Appeals team to resolve payer denials and reduce avoidable denials. Track daily CDI activities including cases...
, Clinical Denials & Appeals). Hands-on experience with large EMR systems such as Cerner, Epic, or Meditech. Proven success...
in documentation. Partner with the Clinical Denials & Appeals team to resolve payer denials and reduce avoidable denials. Track daily...
, you will: Deliver end-to-end process training covering assigned domains within Clinical Denials & Appeals. Facilitate induction training...
to maintain compliance with ICD-10, CPT/HCPCS, and CMS/OIG regulations. Address documentation and coding-related denials...
in documentation. Partner with the Clinical Denials & Appeals team to resolve payer denials and reduce avoidable denials. Track daily...
as needed. Investigate and resolve claim issues, denials, and discrepancies. Conduct payer follow-up to ensure timely reimbursement...
initiatives by ensuring clinical validity and medical necessity in documentation. Partner with the Clinical Denials & Appeals team... to resolve payer denials and reduce avoidable denials. Track daily CDI activities including cases reviewed, queries sent...
to enhance efficiency. Monitor performance metrics, including productivity and accuracy, for all Clinical Denials & Appeals staff...
in documentation. Partner with the Clinical Denials & Appeals team to resolve payer denials and reduce avoidable denials. Track daily...
/OIG regulations. Address documentation and coding-related denials and coordinate with billing and A/R teams to identify...
to maintain compliance with ICD-10, CPT/HCPCS, and CMS/OIG regulations. Address documentation and coding-related denials...
, you will: Oversee daily Clinical Denials and Appeals operations to ensure timely and accurate processing of denied claims. Set... of denials and support accurate claim generation. Communicate team performance and KPIs during Operations Meetings, highlighting...
to resolve claims denials, rejections, or discrepancies, ensuring accurate and timely payment. Establish and negotiate payment...
in resolving payment issues and claim denials Familiarity with billing guidelines and insurance policies Ability to generate...