The support specialist is a support role crucial to the centralized Utilization Review team for time sensitive... authorization tracking and resolution process. Responsible for obtaining and tracking approvals, denials, and additional information...
which may include one or more of the following: DNFB, Pre-AR, Denials, and Claim Edits. Verifies correct discharge disposition... you are interested in is remote or on-site. Individuals who reside in and will work from the following areas are not eligible for remote...
SOX 404 controls. Reviews and responds to correspondence received from payers. Addresses denials in an accurate...
coding experience, post claim denials and ideally Epic. strong focus on claim denials Accepting applications...
of insurance denials, charge posting and payment posting errors. Follow all Managed Care guidelines using the UFJPI Payor... and unresolved issues. Alert Team Leader of backlogs or issues requiring immediate attention. Identify trended denials and report...
are documented and submitted in a timely manner. Collaborate with denials team on difficult or reoccurring denials. Complete tasks...
payer memos and create communication on changes to support teams Respond to claim denials from insurance companies...
and demographic patient information to ensure compliant claims to Third party payers. Resolves problem accounts from payer denials...
inquiries and payer denials. . KEY RESPONSIBILITIES Processes claims, payments, adjustments, refunds, denials, and unpaid...
education to Inpatient coding staff based on audit findings and denials related to Inpatient coding following ICD-10 Coding... and maintains Inpatient facility specific coding guidelines. Attend Inpatient Denials Management meetings. Assists with the...
of insurance denials, charge posting and payment posting errors. Follow all Managed Care guidelines using the UFJPI Payor... and unresolved issues. Alert Team Leader of backlogs or issues requiring immediate attention. Identify trended denials and report...
regarding denials or benefit changes. Maintain an accurate, up to date aging of assigned accounts including AR analysis... reimbursement processes/methodologies. Create and follow up on appeals needed to protest denials or incorrect payments. Review...
regarding denials or benefit changes. Maintain an accurate, up to date aging of assigned accounts including AR analysis... reimbursement processes/methodologies. Create and follow up on appeals needed to protest denials or incorrect payments. Review...
of insurance denials, charge posting and payment posting errors. Follow all Managed Care guidelines using the UFJPI Payor... and unresolved issues. Alert Team Leader of backlogs or issues requiring immediate attention. Identify trended denials and report...
of insurance denials, charge posting and payment posting errors. Follow all Managed Care guidelines using the UFJPI Payor... and unresolved issues. Alert Team Leader of backlogs or issues requiring immediate attention. Identify trended denials and report...
of insurance denials, charge posting and payment posting errors. Follow all Managed Care guidelines using the UFJPI Payor... and unresolved issues. Alert Team Leader of backlogs or issues requiring immediate attention. Identify trended denials and report...
organizational, interpersonal, verbal, and written communication skills. Knowledge of denials management preferred. Special.... Reviews claim denials and rejections pertaining to coding and medical necessity issues and exercises discretion and judgement...
is a remote, work from home position. The Claims Resolution Specialist will work Monday through Friday, standard business hours... to detail, and the ability to multi-task. 100% Remote Opportunity The Sarnova Family of companies includes Digitech Computer...
with mandated standard code sets. The coder scope may involve reviewing coding related denials from payers and recommending the... appropriate action to resolve the claim based on payer guidelines. This position is full time as and 100% remote...
, and payors, the specialist ensures determinations are communicated promptly and accurately to all relevant stakeholders... appropriateness. Generates written appeals to medical necessity-based payor denials for denials prior to admission and concurrent...