Outpatient Denials & Appeals Specialist
Capital Health (US)
Capital Health is hiring for an administrative role focused on outpatient clinical denials, including medical policy and payer criteria. You will triage, route, document, and track denial cases while collaborating with clinical teams to support timely resolution and denial prevention. The position requires a high school diploma with 3+ years in hospital billing or denials-related work; associate or bachelor’s in healthcare or business is preferred. On-site, 40 hours weekly. #J-18808-Ljbffr Capital Health (US)
- Capital Health in Kentucky seeks an Inpatient Denials Specialist to manage and coordinate inpatient denial cases, ensuring proper triage and preparation for appeals in line with payer requirements. You will work with Clinical Appeals RN, CDI, UR/Case Management, and Physician...Suggested
$29.7 - $31.8 per hour
...$31.80 based on experience Job Description The Acute Coding Appeals Specialist integrates medical coding principles and objectivity in the... ...writing appeals for inpatient Diagnosis Related Group, (DRG) denials in order to support the assigned DRG and to address the clinical...SuggestedTemporary workWork at officeLocal areaRemote work- ## Denials Management SpecialistApplylocations: Remote, USAtime type: Full timeposted on... ...SUMMARY**The Denials Management Review Specialist is responsible for performing comprehensive... ..., and government contractors.* Supports appeal development by analyzing denied claims,...SuggestedFor contractorsLive outWork at officeRemote work
- Join TriHealth as a Coding Appeals Specialist - Hospital Billing! TriHealth offers Coding Denials Specialists the opportunity to make a meaningful impact by protecting revenue, reducing financial loss, and ensuring accurate, compliant coding practices across the organization...SuggestedFull timeDay shift
- Ensemble Health Partners is seeking an Acute Coding Appeals Specialist to review and write appeals for inpatient DRG denials, applying ICD-10-CM/PCS, HCPCS, NCCI, CMS and CMG coding knowledge to support accurate billing decisions. The role requires prior inpatient facility...SuggestedRemote job
- TriHealth in Cincinnati is seeking a Coding Appeals Specialist - Hospital Billing to expedite hospital coding denials, protect revenue, and ensure compliant coding across the organization. You’ll apply ICD-9, ICD-10, DRG, CPT, and CDI expertise to resolve complex denials...
- ...Denials Coordinator Hospital Billing Patient Financial Services A hospital denial coordinator... ...with owner areas, coordinating the appeals process, collaborating with departments... ...across eight hospitals, more than 400 outpatient practices, more than 300 labs, a school...Full timeTraineeshipLocal areaShift work
- ...Healthcare Management Services is seeking an Insurance Follow-up Specialist to review and manage hospital and physician billing, coordinate... ...payers, and optimize reimbursements. The role supports denial management, secondary claims, and patient communications in a remote...Remote jobHome office
- UM SPECIALIST# UM SPECIALISTWaverly , OH 45690## Qualifications* **Education... ..., dual diagnosis, PHP, IOP, outpatient).* **Parity & Regulatory... ...within 24 hours of admission).* **Appeal & Peer-to-Peer Coordination:*... ...Experience handling initial denial appeals, gathering peer-to-...
- Jefferson Regional is seeking a Centralized Scheduler to coordinate outpatient diagnostic appointments across multiple hospital departments. The role ensures efficient scheduling, maximizes patient satisfaction, and supports clinical staff. The ideal candidate has a high...Work at office
- ...holding company operating home health, hospice, and senior living communities across the United States. We are seeking a Denials Management Review Specialist to perform comprehensive clinical and regulatory reviews, ensuring medical necessity and payer compliance for audit...Remote job
- UF Health is seeking a denial management specialist to review denied claims, submit reconsiderations or appeals, and optimize enterprise revenue by reducing denials and improving reimbursements. This remote role requires residence in Florida or Georgia and entails collaboration...Remote jobContract work
$86k
...New York. EHS provides inpatient, outpatient, and emergency care to the diverse... ...-DRG assignment Writes clinical appeal letters and supports denial management process Generates clinically... ...Certified Clinical Documentation Specialist (CCDS) AHIMA Certified Coding...Full timeShift work- ...Position Overview The Regional Medicaid Specialist manages Medicaid eligibility, applications... ...determinations and assists with appeals, reconsiderations, or additional documentation... ...documentation of applications, approvals, denials, renewals, correspondence, and case...Weekly payWork at officeLocal area
$80k
...and guidelines. Partners with coding professionals to ensure accuracy of diagnostic and procedural data. Reviews DRG denial letters and writes denial appeal letters, including supporting evidence and guidelines. Collaboration with care coordination, nursing and ancillary...Temporary work- ...certified physician specializing in physical medicine and rehabilitation for a locum tenens position in Kentucky. This role emphasizes outpatient care, particularly in interventional pain management, with procedures including lumbar epidural steroid injections,...Locum
- Position Title Professional Coding Specialist II Department Revenue Integrity Remote Eligibility... ...services and Minor Procedures, resolve denials and work with leadership to put... ...settings, including office/clinic, hospital outpatient, ED/urgent care, ASC, SNF/nursing home,...Full timeWork at officeRemote workFlexible hours
$22 - $25 per hour
Reimbursement Specialist# Reimbursement SpecialistEnlightened Solutions, LLC (ES) - Administrative... ...aging accounts receivable reports, appeals, corrected claims, and reconsiderations... ...deadlines and the ability to resolve claim denials, payment discrepancies, and...Hourly payWork at officeImmediate start- Summary: The Coding Specialist is responsible for reviewing clinical documentation and accurately... ...assurance activities to minimize claim denials. Qualifications: To perform this job... ...Professional Coder), COC (Certified Outpatient Coder), or equivalent credential. 2+ years...Full timeTemporary workWork at officeDay shiftWeekday work
$20 per hour
| Function: | | The Certified Coding Specialist (CCS) is responsible for accurate and compliant... ...to improve coding accuracy, reduce denials, and support optimal reimbursement for behavioral... .... Assist with denial management and appeals related to coding issues. Monitor...Full timeWork experience placementWork at officeImmediate startMonday to FridayShift workWeekend workDay shift$20 - $36 per hour
...together. The Access & Reimbursement Pharmacy Specialist will be responsible for the benefit... ...follow up on prior authorizations and appeals. The role also includes identifying and... ...prior authorization and appeal approval or denial details with customers in a way that is...Hourly payMinimum wageFull timeTemporary workWork experience placementLocal areaRemote workMonday to FridayShift work$19.32 - $24.13 per hour
...the DNV that includes two hospitals, an outpatient center, satellite ED, and an expansive network... ...claim review, claim (277) rejections, denial review, and claim resubmission. Provides... ...g. authorizations, medical records) for appealing denials. Works correspondence as...Full timeTemporary workPart timeWork at officeFlexible hours$20 - $24 per hour
...The Role: You will be responsible for accurately and efficiently posting payments, adjustments, and denials to patient accounts. A strong understanding of various payer systems and medical billing practices is essential for success in this role. What You’ll Be Doing: Payment...Hourly payRemote workFlexible hours- ...coverage, policy, reimbursement development, and implications for system edits. Coordinates research and responds to system inquiries and appeals. Conducts research of claims systems and system edits to identify adjudication issues and to audit claims adjudication for accuracy...
- OU Health is seeking a Professional Coding Specialist II in Oklahoma. This role involves coding encounters, resolving denials, and ensuring compliance across multiple medical specialties. Ideal candidates will have at least 3 years of coding experience, as well as CPC...Remote jobFlexible hours
$37.79 - $39.58 per hour
...year through the system’s 3 hospitals, 1800 physicians and healthcare professionals, more than 80 community-based practices and outpatient centers. At Maimonides Health, our core values H.E.A.R.T drives everything we do. We uphold and maintain Honesty, Empathy, Accountability...Work at office$66.95k
Job Title: Criminal Justice Specialist (LMHC, MHC-LP, LMSW, LCSW)Job Summary:As a Criminal Justice Specialist, you'll deliver evidence-... ...documentations and toxicology tests for clients with active Assisted Outpatient Treatment (AOT)order.Provide 24-hour crisis intervention on-...Full timeSummer workWork at officeWork from homeMonday to FridayFlexible hoursShift work$20.98 - $30.12 per hour
...systems. Assists supervisor with new staff training Accommodates all visitors with accurate information and professionalism. Performs appeals process when appropriate. Promotes accuracy among all accounts by thoroughly reviewing all transactions Maintains a thorough...Immediate startRemote work$50k - $60k
...Join Deloitte's AI & Engineering practice to support hospital denials management to deliver back-end Revenue Cycle Management (RCM) services... ...on denial reasons. Use appropriate templates to develop denial appeal letters for denials and submit to third party payers. Rebill...Full timeRemote workVisa sponsorship$140k - $165k
...Practice Provider - New York Cancer & Blood Specialists Brooklyn/Staten Island, NY... ...| Float Setting: Private Practice, Outpatient Board Certifications: NP-C/PA-C... .... Together, these communities offer an appealing mix of professional opportunity, cultural...Full timePrivate practiceLocal area
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