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Collaborates with Appeals department to overturn claims denials. Coordinates subpoena process between court system, Child Protection Center, and Legal department and facilitates billing process for expert testimony in court cases (clinic setting/Center for Safe and Healthy Children.
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Progressive experience implementing operational improvement plans across all phases of healthcare revenue cycle management including financial clearance, authorization / referral management, registration, billing, follow-up/collections, contract management, denials, underpayments, and vendor management.
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Converses with medical office staff to obtain additional pertinent clinical history/information; notifies of approvals and denials, giving clinical rationale, while providing optimum customer service through professional/accurate communication and maintaining NCQA and health plans required timeframes.
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This role will be responsible for investigating root cause of clinical denials and documenting them in Epic and follow-up of appeal outcome. This role will help to prevent clinical denials related to lack of clinical, lack of authorization and untimely notifications.
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Provides the proper reconciliation for all related posting transactions including, patient and insurance related payments, adjustments, and denials. This position will be responsible for providing the proper reconciliation for all related posting transactions including, patient and insurance related payments, adjustments, and denials.
$21 - $26 an hourTemporaryExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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This includes timely follow up on outstanding denials and assisting in identifying trends that can negatively impact revenue. Report to AR Manager any denial trends that can negatively impact revenue for the assigned region in a timely manner.
$15.2 - $22.8 an hourFull-timeExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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Provides support to leadership facilitating quality improvement by reporting problems, concerns, and opportunities for increased revenue and decreased denials through the quality assurance process.
$18.27 - $30.69Full-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Submits written summary of trends and denials to Supervisor on a monthly basis. Abides by and promotes HIPAA compliance at all times. Utilizes/reviews account information from all available sources; online data, hard copy reports, referral forms, UB/HCFA and EOBs to fully discuss condition with the payor via phone, fax or email.
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Provides education and training to CCSP Leadership and clinical teams regarding quality issues, denial reasons and documentation standards based on trends resulting in technical denials from GMCF. Communicates with other waiver programs as necessary to update on client status regarding current waiver services.
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It includes, but is not limited to, coding patients' encounters, posting Explanations of Benefits, following-up on claims aging, appealing denials, and following up on outstanding balances. Applicants must have at least 2 years of recent experience in billing for internal medicine, family medicine, or urgent care.
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A background in medical claims billing, insurance collections, coding, and/or denials management is desired. Track trends in payer underpayments, coding issues and denials and report to leadership for escalation.
$18 an hourFull-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Partner with operational service line leaders across our Revenue Integrity Business Unit that includes our Denials and Aged AR service lines to assess revenue generation, as well as the ongoing strategic and financial impact of key operational initiatives ensuring alignment with organizational targets.
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The Patient Financial Services Representative ABO is responsible for following up with their assigned payer for various denials, such as No authorization, Eligibility denials. May be assigned to process payments, adjustments, claims, correspondence, refunds, denials, financial/charity applications, and/or payment plans in an accurate and timely manner, meeting goals in work quality and productivity.
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Research denials and determine if there is a legitimate case for overturning the denial. Research denials and determine if there is a legitimate case for overturning the denial. Recognize and obtain missing yet necessary documentation to complete the appeals package.
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This position is responsible for understanding healthcare contracting terms and requirements in order to address underpayments and denials in accordance with regulatory and contractual obligations.
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denials job in Atlanta, GA
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