NewRevenue Coding Analyst Yale New Haven HealthRevenue Coding AnalystNEW HAVEN, CTRequires occasional ability to lift, push and pull objects such as files and office supplies up to 30 pounds and/or continuously up to 10 pounds; and occasional moving about on foot to accomplish tasks, walking long distances or moving from one work site to another. Reviews and handles interventional procedures performed within Diagnostic Radiology, IE: Breast Imaging procedures, Spine Injections, aspirations etc. to ensure all codes have been appropriately assigned for optimum reimbursement under the direction of the Lead.
Medical-Denial Management Specialist Orthopedic Associates of HartfordMedical-Denial Management SpecialistFarmington, CTThe Medical-Denial Management Specialist analyzes and resolves healthcare insurance claim denials by investigating reasons, preparing appeals, communicating with payers, and collaborating with billing staff to ensure proper reimbursement and prevent future denials. Our growing practice is currently seeking a Medical-Denial Management Specialist with Epic experience to join our Billing & Collections team in our Farmington, Connecticut business office.
Outpatient Coder 2 Certified / PB Coding Hartford HealthCare CorpOutpatient Coder 2 Certified / PB CodingFarmington, CTAnalyzes medical records, interprets documentation and assigns proper International Classification of Diseases, Tenth Edition Clinical Modification (ICD‑10‑CM), Current Procedural Terminology/HealthCare Common Procedure Coding System (CPT/HCPCS), modifiers, and Evaluation & Management codes utilizing designated software to include Computer Assisted Coding (CAC) and/or encoder, coding manuals and other reference material as required. Applies strong knowledge of anatomy and physiology, clinical disease processes, pharmacology, and diagnostic and procedural terminology to determine the appropriate assignment of diagnosis and procedure codes.
Outpatient Coder 2 Certified / HIM Coding Hartford HealthCare CorpOutpatient Coder 2 Certified / HIM CodingFarmington, CTAnalyzes medical records, interprets documentation and assigns proper International Classification of Diseases, Tenth Edition Clinical Modification (ICD‑10‑CM), Current Procedural Terminology/HealthCare Common Procedure Coding System (CPT/HCPCS), modifiers, and Evaluation & Management codes utilizing designated software to include Computer Assisted Coding (CAC) and/or encoder, coding manuals and other reference material as required. Reviews accounts returned from various departments (including Customer Service, Billing, Coding Quality, and Revenue Integrity) and processes corrections for clean claim submission or posts claim denial review for appeal.
NewCoding Data Quality Auditor CVS Health CorpCoding Data Quality AuditorCT$18.50–$38.82 / hourResponsible for performing audit and abstraction of medical records (provider and/or vendor) to identify and submit ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical documentation in accordance with all State and Federal regulations and internal policies and procedures. Proficient in abstraction and assignment of accurate medical codes for diagnoses as documented by physicians and other qualified healthcare providers in the office and/or facility setting.
Inpatient Coder 3 Certified / HIM Coding Hartford HealthCare CorpInpatient Coder 3 Certified / HIM CodingFarmington, CTJob Description: Primary Location: Connecticut-Farmington-9 Farm Springs Rd Farmington (10566). Primary Location: Connecticut-Farmington-9 Farm Springs Rd Farmington (10566).
NewCoding Compliance Auditor (ICD-10/CPT) Trinity Health Of New EnglandCoding Compliance Auditor (ICD-10/CPT)Hartford, CTTrinity Health Of New England is seeking a Coding Compliance Specialist to perform chart audits and provide critical documentation and analysis to the audit team and providers. This full-time role requires at least 5 years of coding experience in ICD-10-CM and CPT Coding, along with strong communication skills.
Medical Coding and Billing Assistant 1 Yale UniversityMedical Coding and Billing Assistant 1New Haven, CTPerforms work queue resolution of medical billing charge sessions by reviewing clinical documentation to confirm diagnostic (ICD-10) and procedural (CPT/HCPCS) codes and modifiers, based on charge review edits for Yale Medicine patient clinical services filed to charge review work queues. Required Education and Experience Four years of related work experience, two of them in the same job family at the next lower level, and high school level education; or two years of related work experience and an Associate's degree, or an equivalent combination of experience and education.
Coding and Billing Analyst Yale UniversityCoding and Billing AnalystConnecticut3. Well-developed problem-solving skills with the ability to be innovative, ability to compile comprehensive analysis of data with complex and professional reporting of results, analyze and interpret detailed reports, develop clear conclusions and summarize findings. Whether you are a current resident of our New Haven-based community- eligible for opportunities through the New Haven Hiring Initiative or a newcomer, interested in exploring all that Yale has to offer, your talents and contributions are welcome.
Inpatient Coding / Abstraction Specialist Hybrid Work Environment Hospital for Special CareInpatient Coding / Abstraction Specialist Hybrid Work EnvironmentNew Britain, ConnecticutRequired: Certified Coding Specialist (CCS) or Certified Coding Specialist – Physician-based (CCS-P), or Certified Professional Coder-Payer (CPC-P), or able to achieve certification within 2 years of hire. Educates both medical and clinical staff on appropriate documentation practices, DRG assignment and changes in assignments, modifier usage, changes in software upgrades and communicates guidelines as published by regulatory agencies.
Coding & Documentation Compliance Auditor Hartford HealthCare CorpCoding & Documentation Compliance AuditorHartford, CThealthcare administration, medical coding, or a related field) • 2+ years of experience in coding and billing, or a related field • Strong knowledge of coding and documentation practices, including ICD-10-CM and CPT coding systems • Excellent analytical and problem-solving skills • Strong communication and interpersonal skills • Ability to work in a fast-paced environment and prioritize multiple tasks and projects. Job Description Primary Location: Connecticut-Hartford-100 Pearl Street Hartford (10484) Job: Coding and Billing Organization: Hartford HealthCare Corp.
HIM - Professional Coding Educator - 40hrs Connecticut Children's Medical CenterHIM - Professional Coding Educator - 40hrsHartford, CTProvides annual coding education and ad-hoc education and reference materials to CCMC and CCSG providers and departments related to chart documentation, coding guidelines, CPT charges, ICD diagnoses, and payer policy. Experience: 5+ years Professional Coding Experience, 2+ years with one or more of the following: delivering presentations, conducting one on one education with providers, teaching a coding class, speaking at coding seminars, or related activity.
Inpatient Coding Specialist / Abstraction (Full Time or Per Diem) Hybrid Work Hospital for Special CareInpatient Coding Specialist / Abstraction (Full Time or Per Diem) Hybrid WorkNew Britain, ConnecticutRequired: Certified Coding Specialist (CCS) or Certified Coding Specialist – Physician-based (CCS-P), or Certified Professional Coder-Payer (CPC-P), or able to achieve certification within 2 years of hire. Educates both medical and clinical staff on appropriate documentation practices, DRG assignment and changes in assignments, modifier usage, changes in software upgrades and communicates guidelines as published by regulatory agencies.
NewRegistered Nurse – HCC/RAF Coding Specialist Baystate HealthRegistered Nurse – HCC/RAF Coding SpecialistSpringfield, MassachusettsWorking collaboratively with providers and clinical staff, the HCC/RAF Coding Nurse identifies documentation opportunities, promotes coding accuracy, improves the completeness of patient problem lists, and supports appropriate reimbursement through Medicare Risk Adjustment (RAF) and quality initiatives, including Healthcare Effectiveness Data and Information Set (HEDIS) . This role supports the organization's Population Health and Value-Based Care initiatives by ensuring complete, accurate, and compliant documentation of chronic conditions in accordance with Centers for Medicare & Medicaid Services (CMS) and Hierarchical Condition Category (HCC) guidelines.
On Site - Coding Manager Summit Health IncOn Site - Coding ManagerCT$75,000–$85,000 / yearOur primary, multispecialty, and urgent care providers serve millions of patients in traditional practices, patients' homes and virtually through VillageMD and our operating companies Village Medical, Village Medical at Home, Summit Health, CityMD, and Starling Physicians. We are innovating value-based care and leveraging integrated applications, population insights and staffing expertise to ensure all patients have access to high-quality, connected care services that provide better outcomes at a reduced total cost of care.
Epic Resolute Application Developer (Charge Router and Coding Skills) - 6260321 Accenture PlcEpic Resolute Application Developer (Charge Router and Coding Skills) - 6260321Hartford, CTIn addition to delivering innovative solutions for Accenture's clients, you will work with a highly skilled, diverse network of people across Accenture businesses who are using the latest emerging technologies to address today's biggest business challenges. Dropping orders using chart review-> creating new patient encounter -> dropping an order and signing the order/Unite charge entry ->creating new encounter.
NewRemote HCC Coding Specialist for Risk Adjustment Highmark HealthRemote HCC Coding Specialist for Risk AdjustmentHartford, CTRemote$27.02–$41.85 / hourThis role offers the possibility of remote work, with occasional site visits and a competitive salary range of $27.02 to $41.85 per hour.#J-18808-Ljbffr. Key responsibilities include coding accuracy, compliance with CMS guidelines, and potential participation in coding audits and education.
Pro Fee Coding Specialist Saint Francis Health SystemPro Fee Coding SpecialistNew Haven, CTLicensure, Registration and/or Certification: (CCS) Certified Coding Specialist - American Health Information Management Association (AHIMA), (CPC) Certified Professional Coder - American Association of Professional Coders (AAPC), (BCHH-C) Board Certified Home Health Coding Credentialing - WellSky, (RHIA) Registered Health Information Administrator - American Health Information Management Association (AHIMA), (RHIT) Registered Health Information Technician - American Health Information Management Association (AHIMA), or Hierarchical Conditions Categories (HCCS) from The Compliance Certification Board (CCB). Experience and/or training in the anatomy and physiology of the human body and disease processes in order to understand the etiology, pathology, symptoms, signs, diagnostic studies, treatment modalities, and prognosis of diseases and procedures to be coded, preferred.
NewAccounts Assistant 4 - Coding & Appeals Follow-Up Yale UniversityAccounts Assistant 4 - Coding & Appeals Follow-UpNew Haven, CTA leading educational institution in New Haven is looking for an Acct Assistant 4 to manage follow-ups on insurance claims and coding denials. The ideal candidate will have a solid understanding of CPT and ICD10 coding, as well as experience with Microsoft Office applications.
Code Enforcement Inspector Springfield City Council (Massachusetts)Code Enforcement InspectorSpringfield, MAMakes regular and special inspections of residential buildings and premises for installation and maintenance of structural elements, of space and use under applicable zoning ordinances, and for adequacy, sanitation, and safety of sewage disposal, exits, insect and rodent control, and garbage and rubbish storage and disposal. Makes regular and special inspections of residential buildings and premises for adequacy, sanitation, safety, installation and maintenance of kitchen, bathroom, hot water, heating, lighting, electrical and ventilation facilities.
Urgent Care - Associate Veterinarian - Middletown , {State_Code UsvtaUrgent Care - Associate Veterinarian - Middletown , {State_CodeMiddletown, ConnecticutAn exceptional veterinary hospital, with a dedicated team, is seeking an Associate Veterinarian to provide superior patient and client care to members of its community. This hospital is open to considering veterinarians who are experienced, as well as new graduates who are interested in exploring Urgent Care practice.
Urgent Care - Associate Veterinarian - Madison , {State_Code UsvtaUrgent Care - Associate Veterinarian - Madison , {State_CodeMadison, ConnecticutAn exceptional veterinary hospital, with a dedicated team, is seeking an Associate Veterinarian to provide superior patient and client care to members of its community. This hospital is open to considering veterinarians who are experienced, as well as new graduates who are interested in exploring Urgent Care practice.
NewRemote AI Systems Engineer & Code Trainer DataAnnotationRemote AI Systems Engineer & Code TrainerHartford, CTRemoteIn this remote role, you will design and solve coding problems, create high-quality code, and provide feedback to improve AI models. Enjoy the flexibility of choosing your projects and setting your schedule with competitive pay opportunities.#J-18808-Ljbffr.
NewRemote AI Training Engineer | Code & Systems DataAnnotationRemote AI Training Engineer | Code & SystemsHartford, CTRemoteIdeal candidates have strong programming skills, particularly in Kotlin and other popular languages, and must possess excellent writing skills. A progressive AI development firm is seeking proficient programmers to work remotely from the US.
Remote Medical Billing Coder Fair Haven Community Health CenterRemote Medical Billing CoderNew Haven, CTRemoteHandle all correspondence related to insurance or patient account, contacting insurance carriers, patients and other facilities as needed to get the maximum payments and accounts and identify issues or changes to achieve client profitability. Guided by a Board of Directors, most of whom are patients themselves, we take pride in being a healthcare leader dedicated to delivering high-quality, affordable medical and dental care to everyone, regardless of their insurance status or ability to pay.
Remote Medical Billing Coder Fair Haven Community Health CareRemote Medical Billing Codernew haven, CTRemoteFull timeHandle all correspondence related to insurance or patient account, contacting insurance carriers, patients and other facilities as needed to get the maximum payments and accounts and identify issues or changes to achieve client profitability. Guided by a Board of Directors, most of whom are patients themselves, we take pride in being a healthcare leader dedicated to delivering high-quality, affordable medical and dental care to everyone, regardless of their insurance status or ability to pay.
Medical Billing Specialist Mi Familia & Summit Home Health and HospiceMedical Billing SpecialistHartford, CTRemote$58,000–$74,000The Medical Billing Specialist will be responsible for processing medical claims, managing insurance reimbursements, resolving billing issues, and ensuring accurate and timely revenue cycle operations. Summit Home Health & Hospice is a Texas-based healthcare organization dedicated to enhancing the lives of patients and families through compassionate home health and hospice services.
Senior Consultant, Health Insurance - Risk Regulatory & Compliance Deloitte Touche Tohmatsu LtdSenior Consultant, Health Insurance - Risk Regulatory & ComplianceHartford, CTThe wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. Our purpose comes through in our work with clients that enables impact and value in their organizations, as well as through our own investments, commitments, and actions across areas that help drive positive outcomes for our communities.
Hospital Billing Coordinator Deloitte Touche Tohmatsu LtdHospital Billing CoordinatorCT$50,000–$60,000 / yearOur purpose comes through in our work with clients that enables impact and value in their organizations, as well as through our own investments, commitments, and actions across areas that help drive positive outcomes for our communities. This compensation range is specific to the remote role and takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs.
Manager, Revenue Integrity - 40hrs Connecticut Children's Medical CenterManager, Revenue Integrity - 40hrsEast Hartford, CTReporting to the Revenue Integrity Director, the Manager of Revenue Integrity works collaboratively with others to optimize workflows and related information systems to help ensure accurate, complete, timely documentation, charges and coding of services. Works collaboratively with Professional Coding, Facility Coding and Compliance (when indicated) with performing appropriate reviews, investigating trends and patterns, and providing education regarding documentation, charge capture, charge reconciliation, billing/coding guidelines and denials.
Manager, Office (31422) GI AllianceManager, Office (31422)CT$67,500–$90,000 / yearOur team of clinical and administrative support staff work collaboratively with our physicians and advanced practitioners to provide our patients with the most comprehensive and compassionate care. Solid knowledge and understanding of revenue cycle, collections and payment posting, medical billing, Medicare and Medicaid and third-party payers.
Compliance Auditor Yale UniversityCompliance AuditorNew Haven, CT$68,000–$120,500 / yearThe University is committed to basing judgments concerning the admission, education, and employment of individuals upon their qualifications and abilities and seeks to attract to its faculty, staff, and student body qualified persons from a broad range of backgrounds and perspectives. Whether you are a current resident of our New Haven-based community, eligible for opportunities through the New Haven Hiring Initiative, or a newcomer, interested in exploring all that Yale has to offer, your talents and contributions are welcome.
Manager, Revenue Analytics Yale UniversityManager, Revenue AnalyticsNew Haven, CT$82,000–$131,500 / yearIn collaboration with Epic Project Team, ensure the integrity of EPIC data that is critical to producing accurate Professional Revenue Cycle processes and reporting such as professional billing codes, pricing, work RVU, provider, department, bill areas, report groupers, etc. Collaborate with Yale New Haven Health System to improve clinical workflows that may affect charge capture or result in denials, and perform reconciliation of professional and facility charges, identifying discrepancies and optimizing revenue opportunities.
Emergency Department Physician Essential Healthcare Solutions LLCEmergency Department PhysicianHampton, MA$255–$370 / hourCoastal Virginia: beaches, low cost of living, military-friendly community, easy access to Norfolk, Virginia Beach, Williamsburg, and the Outer Banks. EHS is pursuing a contract to provide board-certified or board-eligible Emergency Medicine physician coverage at the Hampton VA Medical Center in Hampton, Virginia.
Medical Assistant (MA) - Endocrinology Hartford HealthCare CorpMedical Assistant (MA) - EndocrinologyTorrington, CTMay perform basic therapeutic measures under direction of nursing staff or provider; assist in reinforcing patient education; report lab results to patients and follow through with any physician instructions to patients for follow up or change in medication; or call prescriptions into appropriate pharmacy as ordered by providers. vital signs, EKG's, blood glucose monitoring, etc.); provides instructions to patients on how to properly collect sterile specimens; and collects and prepares specimens and paperwork for outside reference lab.
Certified Professional Coder, Full Time Days, 40 Hours, Central Business Office Day Kimball HealthCertified Professional Coder, Full Time Days, 40 Hours, Central Business OfficeConnecticutCertified Professional Coder Job Summary Under the general supervision of the Director of Professional Revenue Cycle, the Certified Professional Coder performs all phases of abstracting, diagnosis coding, charge capture and posting through record analysis. Conduct quarterly chart audits; in collaboration with the Director of Professional Fee Revenue Cycle, provide one-on-one or small group education to clinical staff on audit results while maintaining professionalism.
Quality Improvement Specialist II Baystate HealthQuality Improvement Specialist IISpringfield, MA$66,081–$75,982 / yearActively pursues effective and efficient operations of their respective areasin accordance withHealth New England’s Values, its Code ofConductand the Associate Handbook, while ensuring the adequacy, adherence to and effectiveness of day-to-day business controls to meet obligations with respect to operational, compliance, and conduct. + Usingmedical record and clinical qualityexpertise, performs HEDIS clinical abstraction in both directelectronic medical record (EMR) and physical medical records to auditprovider compliance with HEDIStechnical specifications.
Special Investigation Unit (SIU) Manager CVS Health CorpSpecial Investigation Unit (SIU) ManagerCT$54,300–$159,120 / yearThe Certified Professional Coder (CPC) Manager will oversee a team of medical coders within the Special Investigations Unit (SIU) to ensure compliance with coding practices through comprehensive record reviews for medical, behavioral, transportation, and other healthcare providers. Ensure staff provide detailed written summaries of medical record review findings and ensure the team articulates findings effectively to investigators, Medicaid plan leadership, law enforcement, legal counsel, providers, and state regulators.
Hospital Billing Operator Deloitte Touche Tohmatsu LtdHospital Billing OperatorCT$70,000–$90,000 / yearOur purpose comes through in our work with clients that enables impact and value in their organizations, as well as through our own investments, commitments, and actions across areas that help drive positive outcomes for our communities. This compensation range is specific to the remote role and takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs.
Medical Administrative Associate - Outpatient Child/Adolescent Psych Clinic Hartford HealthCare CorpMedical Administrative Associate - Outpatient Child/Adolescent Psych ClinicHartford, CTResponsible for full range of administrative support in a medical office setting providing duties from scheduling appointments, calling pharmacies, billing patients and verifying precertification's to triaging phone calls from patients, physicians and insurance companies, while maintaining patient and business confidentiality to ensure that the needs of the internal and external customers are met. As a Hartford HealthCare entity, The Hartford Hospital Institute of Living provides eligible employees with an extensive benefits package and all the benefits of working in a thriving centrally located urban community: Medical and dental benefits.
Outpatient Clinical Denial Specialist (Remote) Yale New Haven HealthOutpatient Clinical Denial Specialist (Remote)New Haven, CTRemoteCertified Coding Specialist (CCS), Certified Coding Specialist Physician based (CCS-P) certification through the American Health Information Management Association (AHIMA) and/or Certified Professional Coder (CPC) or Certified Outpatient Coder (COC) through American Academy of Professional Coders (AAPC) or similar certification is required, or must be obtained within a year of hire. This individual is responsible for, but not limited to: managing medical denials by conducting a comprehensive review of clinical documentation, writing compelling arguments based on the clinical documentation and the medical policies of the payor, submitting appeals in a timely manner, and identifying/resolving denial trends to mitigate potential loss.
Clinical Department Liaison Yale UniversityClinical Department LiaisonNew Haven, CT$68,000–$120,500 / yearThis position is accountable for independently addressing the department's clinical revenue cycle and compliance concerns, identifying and resolving issues affecting the professional clinical revenue stream, and implementing measures to minimize financial and operational risks while optimizing the efficiency of charge capture for billable services. As a high-level individual contributor, the Liaison coordinates with clinical teams and YM to facilitate new workflows, troubleshoot Epic-related issues, and resolve inquiries from providers regarding training, documentation requirements, and coding.
YM New Provider Auditor and Educator Yale UniversityYM New Provider Auditor and EducatorNew Haven, CT$82,000–$131,500 / yearThe University is committed to basing judgments concerning the admission, education, and employment of individuals upon their qualifications and abilities and seeks to attract to its faculty, staff, and student body qualified persons from a broad range of backgrounds and perspectives. Whether you are a current resident of our New Haven-based community, eligible for opportunities through the New Haven Hiring Initiative, or a newcomer, interested in exploring all that Yale has to offer, your talents and contributions are welcome.
Research Billing Compliance Analyst Yale UniversityResearch Billing Compliance AnalystConnecticutRequired Education and Experience Bachelor’s Degree in Health or Business Administration or a related field and 3 years of experience working directly with clinical research charge review and billing or an equivalent combination of education and experience. Whether you are a current resident of our New Haven-based community- eligible for opportunities through the New Haven Hiring Initiative or a newcomer, interested in exploring all that Yale has to offer, your talents and contributions are welcome.
Centralized Billing Specialist - Full Time - In-Person or Remote Community Health Center IncCentralized Billing Specialist - Full Time - In-Person or RemoteMiddletown, CTRemoteOrganization Information: Community Health Center, Inc. (CHC) with offices in Connecticut, Colorado and California, is one of the country's most creative and dynamic providers of primary medical, dental, and behavioral health services, and a leader in practice-based research, health professionals training, and use of innovative technologies to advance health and healthcare. In addition, the organization has developed three wholly owned subsidiaries from the original pilot developments within the Weitzman Institute: the National Nurse Practitioner Residency and Fellowship Training Consortium (NNPRFTC), the National Institute for Medical Assistant Advancement (NIMAA), and the ConferMED Network.
Nurse Practitioner - PPV CompassusNurse Practitioner - PPVCTThe Nurse Practitioner, if providing hospice care, functions as an extension of the interdisciplinary team (IDT) and hospice physician to provide routine recertification and emergency assessments, educational, and evaluative services to meet the needs of patients and their families. If providing Hospice Face to Face Visits: Performs routine and emergency assessments: Completes routine and emergency recertification visits on each patient entering their 3rd benefit period or beyond (including admissions and transfers).
Radiology Tech, ProHealth Physicians Glastonbury CT Base UnitedHealth Group IncRadiology Tech, ProHealth Physicians Glastonbury CT BaseGlastonbury, CT$23.89–$42.69 / hourThe fraudulent LinkedIn messages and emails, which do not originate from any Executives LinkedIn account or of UnitedHealth Group's email domains, or those of any of its operating divisions, supposedly conducts an interview via a Zoom meeting, offers a work from home job at Optum, emails an application, sends a fake check by next day delivery through USPS and asks recipients to pay a vendor a large dollar amount. Requisition number: 2365669 Job category: Healthcare Delivery Primary location: Glastonbury, CT Additional locations: Meriden, Connecticut | Manchester, Connecticut | Torrington, Connecticut | West Hartford, Connecticut | Bristol, Connecticut Date posted: 06/02/2026 Overtime status: Non-exempt Travel: No.
Insurance Reimbursement Specialist Aspira Womens Health Inc.Insurance Reimbursement SpecialistShelton, CTReview claim denials within 1 week of posting to determine next step for accession Submit request to provider for necessary documentation for appeal- follow up on requests within 2 weeks if not received Submit accessions for adjustments per Patient Transparency Program guidelines and document accession to reflect need for adjustment accurately Follow up with plans when trends of nonpayment or incorrect payment is received per contracts Utilize portals/fax/USPS to submit appeals for claim review when necessary. Responsible for submission of appeals to national payers Provide review of all levels of an insurance appeal Gather supporting documentations (physician medical records, patient /physician letters etc.) Work incoming correspondence from payors to assist with claim appeal Interact with utilization review/management departments Assist with gathering EOB's if cash poster is unable to locate Provide excellent customer service via the handling of inbound and outbound calls/emails to patients and providers.
Part-time Lecturer-Nursing, Allied Health & Human Services Connecticut State Colleges & UniversitiesPart-time Lecturer-Nursing, Allied Health & Human ServicesCTConnecticut State Community College commits to bold and disruptive change by actively identifying, naming, and dismantling structural racism, systemic poverty, and other barriers; establishing equitable and anti-racist policies and practices; and empowering students, faculty, staff, and administrators to advance racial, social, and economic justice. Employment Type: Part-Time, Adjunct Anticipated Start Date: Continuous Recruitment Work Location: CT State CC - Multiple campuses Work Modality: Classes may be taught on ground, online synchronously or asynchronously, or as hybrid.
Nurse Practitioner or Physician Assistant - Senior Care (Per Diem) - Litchfield & Hartford Counties, CT UnitedHealth Group IncNurse Practitioner or Physician Assistant - Senior Care (Per Diem) - Litchfield & Hartford Counties, CTHartford, CTProgram Enhancement Expected Behaviors Regular and effective communication with internal and external parties including physicians members key decision-makers nursing facilities CCM staff and other provider groups Actively promote the CCM program in assigned facilities by partnering with key stakeholders i e internal sales function provider relations facility leader to maintain and develop membership growth Exhibit original thinking and creativity in the development of new and improved methods and approaches to concernsissues Function independently and responsibly with minimal need for supervision Ability to enter available hours into web-based application at least one month prior to available work time Demonstrate initiative in achieving individual team and organizational goals and objectives Participate in CCM quality initiatives Availability to check Optum email intermittently for required trainings communications and monthly scheduling Youll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide. Care Coordination Understand the PayerPlan benefits CCM associate policies procedures and articulate them effectively to providers members and key decision-makers Assess the medical necessityeffectiveness of ancillary services to determine the appropriate initiation of benefit events and communicate the process to providers and appropriate team members Coordinate care as members transition through different levels of care and care settings Monitor the needs of members and families while facilitating any adjustments to the plan of care as situations and conditions change Review orders and interventions for appropriateness and response to treatment to identify most effective plan of care that aligns with the members needs and wishes Evaluate plan of care for cost effectiveness while meeting the needs of members families and providers to decreases high costs poor outcomes and unnecessary hospitalizations.