Clinical Denials and Appeals Expert

6 days ago


Annapolis, Maryland, United States Insight Global Full time
Job Overview

We are seeking a highly skilled Clinical Denials and Appeals Expert to join our team at Insight Global.

The estimated salary for this position is $85,000 - $110,000 per year, depending on experience.

About the Role

This is a hybrid role that requires strong analytical and communication skills. As a Clinical Denials and Appeals Expert, you will work closely with our denial management department to review claims denied for coding-related root causes and suggest process improvements to reduce future denials.

You will be responsible for performing retrospective and prospective account reviews, analyzing coding-related denials, and developing process improvements for coding and documentation workflows. You will also provide regular feedback to denial management team members and coding/physician educators to promote departmental knowledge of best practices within coding.

Key Responsibilities
  1. Perform retrospective and prospective account reviews to ensure accurate coding and documentation.
  2. Analyze coding-related denials to identify trends and root causes.
  3. Develop process improvements for coding and documentation workflows based on denial analysis and industry coding guidelines.
  4. Organize data into clear reports for denial management leadership, physician advisors, and providers.
  5. Provide regular feedback to denial management team members and coding/physician educators.
Requirements

To be successful in this role, you will need:

  • A minimum of 3 years of coding, denial management, and/or reimbursement experience.
  • Current coding certification (RHIA, RHIT, CPC, CCS).
  • Strong analytical and communication skills.
  • Ability to work independently and as part of a team.


  • Annapolis, Maryland, United States Anne Arundel Urology Full time

    Job OverviewAn estimated salary range for this position is $45,000 - $65,000 per year.We are seeking a highly skilled Medical Billing Specialist to join our team at Anne Arundel Urology.ResponsibilitiesCoordinate all billing and collections processes.Key in charges and payments accurately.Research unpaid claims and determine the cause of denial.Submit...


  • Annapolis, Maryland, United States Luminis Health Full time

    Job SummaryWe are seeking an experienced and skilled Senior Nurse Leader to join our team at Luminis Health as a Clinical Supervisor for the ICU/IMU department. This is a full-time position working days, with a competitive salary range of $85,000 - $110,000 per year.About the RoleThe Clinical Supervisor will be responsible for direct supervision of staff,...


  • Annapolis, Maryland, United States Luminis Health Full time

    Luminis Health seeks a skilled Critical Care Nursing Expert to join our team.**Job Summary:**We are seeking a highly experienced Clinical Nurse Specialist to provide expert clinical leadership and support to our ICU team. The ideal candidate will have a strong background in critical care nursing, excellent communication skills, and the ability to work...

  • Healthcare Leader

    1 week ago


    Annapolis, Maryland, United States Luminis Health Full time

    Job SummaryWe are seeking a highly skilled and experienced Clinical Supervisor to join our team at Luminis Health. This is a fantastic opportunity for a seasoned professional to lead and mentor staff, drive clinical excellence, and contribute to the delivery of high-quality patient care.


  • Annapolis, Maryland, United States Luminis Health Full time

    Job Summary:We are seeking a highly skilled Registered Nurse to join our team at Luminis Health. As a key member of our healthcare team, you will be responsible for delivering high-quality patient care and contributing to the provision of excellent healthcare services.Key Responsibilities:Clinical Decision Making/Judgment: Utilize clinical nursing knowledge...


  • Annapolis, Maryland, United States Power3 Solutions and Partnering Companies Full time

    Power3 Solutions and Partnering Companies is seeking an experienced Cybersecurity Expert to protect its systems and data.About the JobThe ideal candidate will have a wealth of knowledge and expertise in ensuring the security and integrity of systems and data.Main ResponsibilitiesAct as the primary point of contact for security-related matters.Conduct regular...


  • Annapolis, Maryland, United States Luminis Health Full time

    About the Role We are seeking a highly skilled Medical Coding Specialist to join our team at Luminis Health. As an integral part of our coding department, you will be responsible for ensuring accurate and efficient code assignment in accordance with ICD-10-CM guidelines.Key Responsibilities Review medical records to extract pertinent information for code...


  • Annapolis, Maryland, United States Luminis Health Full time

    Job SummaryWe are seeking a highly skilled Wound Ostomy Nurse (WON) to join our team at Luminis Health. As a Medical Care Specialist, you will serve as a clinical resource and consultant for the acute care setting within our hospital.Key ResponsibilitiesProvide expert consultation and direct assistance to nursing staff on issues related to patients with...


  • Annapolis, Maryland, United States vTech Solution, Inc. Full time

    About vTech Solution, Inc.vTech Solution, Inc. is a forward-thinking organization committed to delivering top-notch patient care. As a Clinical Healthcare Provider, you will play a vital role in our team, collaborating with patients and healthcare experts to deliver exceptional care.CompensationThe estimated annual compensation for this role is $60,000 -...

  • Staff Nurse

    4 days ago


    Annapolis, Maryland, United States Luminis Health Full time

    Job Title:Staff NurseJob Summary:Luminis Health is seeking a dedicated and compassionate Staff Nurse to join our team. This role offers a unique opportunity to make a positive impact on patients' lives while advancing your own clinical skills.About the Role:We are looking for a highly skilled and motivated nurse who can contribute to the provision of...


  • Annapolis, Maryland, United States Luminis Health Full time

    Job SummaryLuminis Health seeks a dedicated and experienced Clinical Supervisor to join our team. As a key member of our leadership staff, this individual will play a vital role in ensuring the highest level of patient care and satisfaction.Responsibilities:Supervision and Leadership: Directly supervise staff, providing guidance and support to ensure optimal...

  • Data Science Leader

    6 days ago


    Annapolis, Maryland, United States Ernst and Young Full time

    We are seeking a highly skilled Data Science Leader with expertise in cloud technologies to join our team at Ernst and Young. As a leader in this field, you will be responsible for driving the development of advanced data science solutions that meet the evolving needs of our clients.With a strong background in machine learning and experience working with...


  • Annapolis, Maryland, United States Strides Therapy and Educational Services Full time

    Job Title:Clinical Fellow Speech Language PathologistAbout the Role:We are seeking a highly motivated Clinical Fellow Speech-Language Pathologist to join our team at Strides Therapy & Educational Services. As a key member of our interdisciplinary team, you will work closely with students, educators, and families to assess, diagnose, and treat communication...


  • Annapolis, Maryland, United States Korzen Health Full time

    About Korzen HealthKorzen Health is a renowned healthcare group in the greater Baltimore area, with over 37 years of experience serving communities such as Anne Arundel County, Severn, and Baltimore.We are seeking an experienced Chiropractor to join our team due to growth and a recent partnership with Chiropractic Health Partners.Practice OverviewOur...


  • Annapolis, Maryland, United States RadNet Full time

    Company OverviewRadNet is a leading radiology provider with decades of expertise in delivering quality, value, and access in the 21st century.We align all stakeholders – patients, providers, payors, and regulators – to achieve the best clinical outcomes.


  • Annapolis, Maryland, United States Luminis Health Full time

    Job SummaryWe are seeking a dedicated and compassionate Staff Nurse to join our team at Luminis Health. As a key member of our healthcare team, you will provide high-quality patient care, collaborating with colleagues to ensure exceptional outcomes.Key ResponsibilitiesClinical Decision Making/Judgment: Utilize clinical nursing knowledge and skills to assess...


  • Annapolis, Maryland, United States Luminis Health Full time

    About the RoleThis critical care team lead position is an exciting opportunity to join Luminis Health as a Clinical Supervisor for the ICU/UMU unit.ResponsibilitiesDirectly supervise staff and serve as a clinical expert practitioner specific to the unit, responsible for education/staff development functions and designated management duties to promote...


  • Annapolis, Maryland, United States Luminis Health Full time

    About the RoleWe are seeking a highly skilled Nursing Professional to join our team at Luminis Health. In this role, you will have the opportunity to make a meaningful impact on the lives of our patients and their families.Key Responsibilities:Contribute to the provision of high-quality patient care as a member of our healthcare team.Demonstrate clinical...

  • Nursing Unit Leader

    5 days ago


    Annapolis, Maryland, United States Luminis Health Full time

    Job SummaryWe are seeking an experienced RN to fill the position of Clinical Team Manager at Luminis Health. This role will involve supervising a team of nurses and providing expert clinical knowledge and skills in patient care.About the RoleAs a Clinical Team Manager, you will be responsible for coordinating patient care, serving as a clinical resource for...


  • Annapolis, Maryland, United States Luminis Health Full time

    We are seeking a highly skilled Wound Ostomy Nurse to join our team at Luminis Health in Annapolis, MD.About the RoleAs a Wound Ostomy Nurse, you will serve as a clinical resource and consultant for the acute care setting, providing expert care to patients with selected disorders of the gastrointestinal, genitourinary, and integumentary systems.Key...