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Extensive knowledge of Medicare Managed Care organization determination, appeals and grievance requirements, specifically reconsideration and IRE submission requirements. Demonstrate understanding of the appeals and grievance processes, including all regulatory and reporting requirements.
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Involved in the clinical denial/appeal process for DRG challenges and clinical validations via Clinical Validation Audits/Denial Prevention, reviewing technical payor denials and determines if an appeal is justified and author appeals.
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Support the integration of CPQ and Billing application to the Workday Financials. 5+ years of experience implementing and supporting large scale, technically complex solutions on Salesforce ecosystem Experience integrating the Salesforce platform with internal and external systems Programming background using one or more of the languages such as APEX, Visualforce, Lightning, Java. Enterprise integration architectures such as SOA, RESTful, ETL Deep understanding of CPQ, SaaS and subscription billing processes.
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Responsible for completing case report forms, entering clinical research data, and assist with regulatory submissions to the IRB. Provides limited patient contact as needed for study and assist with study budget and patient research billing.
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Responsible for overseeing day to day activities of admitting and registration, patient billing and collection, third-party payers, and denials management. The ideal candidate will have experience leading financial operations for an ambulatory surgical center, including budgeting, preparing financial statements, and directing revenue cycle management activities such as patient access, registration, charging, billing, and collecting.
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Collect & review subcontract billing documents for completeness and enter into the financial system · Analyze and track Subcontractor and sub-tier lien waivers · Document and track Subcontractor payment deficiency items until cleared obtaining lien waivers for all payments.
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Oversees the daily operations of the General Accounting (Accounts Payable, Purchasing and Patient Financial Services), Revenue Cycle (Admitting / Registration and Billing and Collections), Health Information Management, Budget / Decision Support, and Payroll departments.
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Maintain a billing binder that includes the Register of Daily Attendance for all districts, LAUSD and other district’s daily case notes, the Welligent Monthly Reports, and the Daily Service Log ensuring all information is reconciled and give the completed and reconciled Clinical Binders to the NPS Clinical Supervisor weekly for billing purposes.
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Work across functional lanes to help monitor and improve all aspects of revenue cycle, including, but not limited to, patient registration, insurance verification, authorization, co-pay collection, billing, AR follow-up, denial management, payment posting, refund and account reconciliation.
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Familiarity with CPT, HCPCS, ICD-10 coding, revenue codes, and hospital billing/claims processing. Five or more years of experience in revenue/accounts receivable financial analysis, claims or billing analysis, decision support, or economics in a healthcare setting.
$50 - $56RemoteExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Assist university stakeholders in completing parking permit purchases, citation appeals, special permit and transit subsidy applications, and reservations utilizing software and payment processing systems.
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Minimum of two year experience in front office/medical billing and/or current hospital registration/admitting. Minimum of two year experience in insurance verification and/or medical/hospital billing.
$20.47 - $33.78 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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The Assistant Property Manager is responsible for the repair and maintenance of plaza properties and performs lease administration work related to billing, accounts payable, and accounts receivable.
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Proven experience with high cost biologics and in-depth knowledge on issues related to billing, coding, appeals across physician types. The Field Reimbursement Manager (FRM) proactively provides education and support on product access programs for physicians and their staff.
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In-depth knowledge of private and governmental insurance eligibility and verification, charge capture, CPT maintenance, coding, billing and collections, payment posting and self-pay. Thorough understanding of CMS (Medicare / Medicaid) billing regulations.
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billing appeals jobs in Los Angeles, CA
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