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The Clinical Appeals Specialist ensures that appeals are thoroughly reviewed, accurately documented, and effectively communicated to insurance providers, healthcare professionals, and members. ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations.

Independent Living Systems LLC

Clinical Appeals Specialist

Reviews and analyzes denied claims, prepares and submits comprehensive appeals, collaborates with physicians, Health Information Management (HIM), Case Management, Coding, Patient Financial Services, and other interdisciplinary teams to resolve denials, identify root causes and denial trends, and support denial prevention and revenue optimization initiatives. Collaborates with physicians, Physician Advisors, Coding, Clinical Documentation Integrity (CDI), Health Information Management (HIM), Case Management, Utilization Management, Revenue Integrity, Patient Financial Services, and other interdisciplinary departments to obtain supporting documentation, strengthen appeals, resolve denials, and improve reimbursement outcomes.

NorthBay Medical Center

Clinical Denials Specialist (On-Site)

FULL_TIME

As a Coordinator Marketing Linkage , you will assist in providing our Owners/guests with experiences and events to make memorable vacation memories, where meaningful moments are made together. Successful candidates will be highly motivated with sales or customer service experience and enjoy interacting with guests either in person or by phone.

Marriott Vacations Worldwide

Vacation Specialist - based at Westin Hapuna

CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED: Must be a Certified Coding Specialist (CCS), Certified Coding Specialist - Physician(CCS-P) through AHIMA(American Information Management Association) or AAPC's (American Academy of Professional Coders) Certified Professional Coder(CPC) credential or Certified Professional Coder-Hospital (CPC-H). frame-loader#lazyLoad clinch:authenticated@document->frame-loader#reload" data-controller="frame-loader" data-src="/blocks/jobs/829a89be4f3b4343dcbf7b6d3b85348f/favourites?page_id=307adbbfc8bd0f5a14f95c1c6bbc3490" id="829a89be4f3b4343dcbf7b6d3b85348f_favourites">.

YEAR

Boston Medical Center

Coding Education Specialist

Certification in at least ONE of the following: Certified Coding Specialist (CCS) from AHIMA or Certified Professional Coder Instructor (CPC-I), Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA), Certified Physician Practice Manager (CPPM), Certified Documentation Expert Outpatient (CDEO), or Certified Professional Compliance Officer (CPCO) from AAPC. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information.

The University of Texas at Austin

Provider Coding Education Specialist

Provide billing leadership with regular reports on charges and claims billed, cash received, unbilled accounts, aging receivables, denials and rejections, notice timeliness, authorizations, held claims, and recurring causes of delay. Billing readiness and issue resolutionCheck for required billing elements and documentation status, including orders, certifications and recertifications, face to face documentation where applicable, election documents, and plan of care status.

HOUR

Aegis Healthcare

Billing Specialist (Home Health and Hospice)

Talent Acquisition

We offer the latest in advanced medicine, technology, and comfort in 12 facilities across Miami-Dade (including our 674-bed main campus facility) and Monroe Counties, with 38 medical services, including cancer care, 24/7 emergency care, orthopedics, cardiovascular care, and more. FLORIDA RESIDENCY REQUIRED (REMOTE)Experienced Inpatient Coding Specialist responsible for accurately coding and abstracting inpatient medical records using ICD‑10‑CM and ICD‑10‑PCS with a minimum 95% accuracy rate.

Mount Sinai Medical Center of Florida

Certified Inpatient Coding Specialist CCS

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Licenses / Certifications: At least one of the following active certification/licenses required: · CDIP: Clinical Documentation Improvement Practitioner · CCDS: Certified Clinical Documentation Specialist · CCS: Certified Coding Specialist, or equitable coding credential Preferred minimum requirement: · RHIT/RHIA: Registered Health Information Technician/Administrator · RN: Current/active license as a registered nurse in the state of residence or current /active RN license with the ability to transfer license to state of residence within three months of start. Responsibilities require interaction with physicians, nursing staff, medical records coding staff, compliance specialists and other healthcare providers to ensure that clinical information in the medical record is present and accurate so that the appropriate utilizations, clinical severity, outcomes and quality are captured for the level of service rendered and ensure compliant reimbursement of patient care services.

Westchester Medical Center Health Network

Clin. Documentation Specialist

Other job duties include: improving health record documentation and coding accuracy, developing and updating all departmental policies and procedures relative to coding, performing quality reviews of coding/abstracting, and focusing on problem solving issues related to denials. Working directly with the physicians, Manager of Corporate Coding Services, Director of Registration/Admitting, and medical staff education efforts, serves as the user advocate between Health Information Management (HIM), Clinical Effectiveness, and Registration.

Covenant Health

Coding Specialist

Conducts comprehensive reviews of the claim denial, account/guarantor notes associated with the denial, and the medical record to make determinations if a revised claim needs to be submitted, if a retro authorization needs to be obtained, if a written appeal is needed, or if no action is needed. The individual is responsible for resolving coding claim edits, coding-related claim denials & coding correspondence, monitoring for trends and assist in the analysis, development, and implementation of solutions to minimize avoidable denials and adjustments.

Medical College of Wisconsin

Coding Denials Specialist - Clinical Practice Services

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Refers charts that require clarification of vague or unclear documentation for accurate coding and DRG assignment to a Coding Quality Specialist to query the physician for the needed documentation.

Penn Medicine

HIM Inpatient Coding Specialist III

Jobvite Talemetry Organic Easy Apply

The Specialist maintains accurate financial and payer information in the department’s electronic health record (EHR), including myEvolv, and works closely with the DHS Medical Billing Coordinator, program staff, clients, responsible parties, insurance carriers, and other payers to support timely and accurate reimbursement. • Generates and reviews monthly client statements for BT3, CLTS, Integrated Behavioral Health Services (IBHS), Partial Hospitalization Program (PHP), and other County-funded treatment services, including room and board, residential treatment, and inpatient hospital services, as applicable.

Ozaukee County

DHS Billing Specialist

partner JazzHR

Bachelor of Science degree from an accredited college/university AND successful completion of an ASCP/NAACLS-accredited Medical Technology/Medical Laboratory Science program OR; Bachelor of Science degree from an accredited college/university with a major in biological, chemical, physical or clinical laboratory science AND ASCP categorical certification OR; Bachelor of Science degree from an accredited college/university with a major in biological, chemical, physical, or clinical laboratory science AND at least two years' experience in a role equivalent to that of a Medical Laboratory Technician (MLT) in a clinical laboratory. Communication, Computer Literacy, Laboratory Equipment Operation, Laboratory Information Systems (LIS), Laboratory Services, Laboratory Supply And Inventory Management OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities.

For communities across the country, health doesn’t have to be a destination: It can be a daily opportunity. At Geisinger, we empower our communities to do well and be well by removing barriers to advanced healthcare in all the moments where health makes its home.

For more than 100 years, we’ve served our region while working to create a national model for improving health. Today, we’re focused on bringing them services that improve every facet of life to drive total health, inside and out.

Geisinger

Information Specialist Medical Laboratory (HYBRID) Scientist

The Facility Biller & AR Specialist will review coding, correct and submit front-end rejections from the clearing house, review rejections from third party payers, along with analyzing and monitoring any aged accounts receivables through identifying areas of concern by age, category, payer, provider specialty, and facility to order to resolve claim issues and resubmit in a timely manner. We are seeking a motivated individual who is detail oriented and takes a collaborative team approach to problem solving, the Facility Biller & AR Specialist performs the day-to-day billing and follow-up activities concerning facility claims for multiple locations, and specialties.

Insight

Facility Biller

RESPONSIBILTIES AND PERFORMANCE EXPECTATIONS include, but are not limited to, the following: Assesses adequacy of health record documentation in order to support accurate, complete and specific assignment of modifiers, International Classification of Diseases (ICD), Current Procedural Terminology (CPT) and Health Common Procedural Coding (HCPC) codes to maximize reimbursement. POSITION SUMMARY: Under general supervision the position is responsible for billing, coding, posting, assigning correct payer sources, submitting clean claims to insurances and follow up for on denial claims in order to maximize the revenue cycle through billing and coding expertise.

Central Florida Health Care, Inc.

Billing and Coding Specialist

Build strong referral networks outside the sites of care by educating and selling our four marketed products with the ultimate goal of identifying new patients or patients diagnosed and lost to follow up. NCSS is expected to consistently meet and frequently exceed enrollment form goals, thrive in a fast-paced, collaborative environment, understand market dynamics, demonstrate excellent judgment, and be motivated by the desire to improve patients'' lives.

Sarepta Therapeutics Inc

Senior Neuromuscular Clinical Sales Specialist - Mountain West

Utilizes encoder software applications, which includes all applicable online tools and references in the assignment of International Classification of Diseases, Clinical Modification (ICD-CM) diagnosis and procedure codes, and Current Procedural Terminology (CPT) / Healthcare Common Procedure Coding System (HCPCS) procedure codes and all required modifiers. REQUIRED KNOWLEDGE, SKILLS AND ABILITIES: Completion of an AHIMA-approved coding program or an AAPC-approved coding program, or Associate degree in Health Information Management or a related field or an equivalent combination of years of education and experience is required.

Coding Specialist II

Must have one of the following certifications: Certified Outpatient Coder, Certified Coding Specialist, Certified Professional Coder thru AAPC or Registered Health Information Technologist or Registered Health Information Administrator thru AHIMA. Comprehensive proficiency with Microsoft product suite (MS Word, Excel, Power Point, etc.); Ability to use other software as required to perform the essential functions of the job.

Trinity Health is one of the largest not-for-profit, faith-based health care systems in the nation. It is a family of 121,000 colleagues and nearly 36,500 physicians and clinicians caring for diverse communities across 27 states. Nationally recognized for care and experience, the Trinity Health system includes 101 hospitals, 126 continuing care locations, the second largest PACE program in the country, 136 urgent care locations and many other health and well-being services. In fiscal year 2023, the Livonia, Michigan-based health system invested $1.5 billion in its communities in the form of charity care and other community benefit programs.

Trinity Health

Certified Risk Adjustment Coding Specialist

Program HQ AFRC/SG Aeromedical Case Management Support (Contract FA664326C0002) Employer Unified Health Partners, LLC (Prime) Location HQ AFRC, Robins AFB, Warner Robins, GA (on-site) Employment type Full-time, non-exempt (SCA) Labor category SCA 12190 – Medical Record Technician Reports to Lead Medical Case Manager / Focal Point (UHP) Positions 1.0 FTE   Essential Healthcare Solutions is supporting Unified Health Partners, LLC (UHP). Load cases into the appropriate electronic system of record and update AIMWTS, ECT, PEPP, MEDXS, and PSC tracking with current case status as status changes — the highest-volume queue (~1,350 data/status updates per month).

Essential Healthcare Solutions LLC

Medical Case Manager-Admistrative Specialist-Intake and Daty Entry

Crelate

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Medical Reimbursement Specialist Jobs in the United States

Clinical Appeals Specialist Independent Living Systems LLC

Clinical Denials Specialist (On-Site) NorthBay Medical Center

Vacation Specialist - based at Westin Hapuna Marriott Vacations Worldwide

Coding Education Specialist Boston Medical Center

Provider Coding Education Specialist The University of Texas at Austin

Billing Specialist (Home Health and Hospice) Aegis Healthcare

Certified Inpatient Coding Specialist CCS Mount Sinai Medical Center of Florida

Clin. Documentation Specialist Westchester Medical Center Health Network

Coding Specialist Covenant Health

Coding Denials Specialist - Clinical Practice Services Medical College of Wisconsin

HIM Inpatient Coding Specialist III Penn Medicine

DHS Billing Specialist Ozaukee County

Information Specialist Medical Laboratory (HYBRID) Scientist Geisinger

Facility Biller Insight

Billing and Coding Specialist Central Florida Health Care, Inc.

Senior Neuromuscular Clinical Sales Specialist - Mountain West Sarepta Therapeutics Inc

Coding Specialist II Insight

Certified Risk Adjustment Coding Specialist Trinity Health

Medical Case Manager-Admistrative Specialist-Intake and Daty Entry Essential Healthcare Solutions LLC

Billing/Budget Specialist (226 Days) Dallas Independent School District

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