Williamsburg, VA · On-site
$362K/yr
... denials management, support documentation integrity as it pertains to accurate coding capture. The Regional Physician Advisor interfaces with hospital and medical staff leadership, facilitating ...
Williamsburg, VA · On-site
$362K/yr
... denials management, support documentation integrity as it pertains to accurate coding capture. The Regional Physician Advisor interfaces with hospital and medical staff leadership, facilitating ...
The Physician Advisor conducts timely and compliant medical necessity reviews and assists with denials management (facilitating and completing peer to peers, writing appeal letters) in support of the ...
The Physician Advisor conducts timely and compliant medical necessity reviews and assists with denials management (facilitating and completing peer to peers, writing appeal letters) in support of the ...
The Physician Advisor conducts timely and compliant medical necessity reviews and assists with denials management (facilitating and completing peer to peers, writing appeal letters) in support of the ...
The Physician Advisor conducts timely and compliant medical necessity reviews and assists with denials management (facilitating and completing peer to peers, writing appeal letters) in support of the ...
... denials management, support documentation integrity as it pertains to accurate coding capture. The Regional Physician Advisor interfaces with hospital and medical staff leadership, facilitating ...
... denials management, support documentation integrity as it pertains to accurate coding capture. The Regional Physician Advisor interfaces with hospital and medical staff leadership, facilitating ...
... denials management, support documentation integrity as it pertains to accurate coding capture. The Regional Physician Advisor interfaces with hospital and medical staff leadership, facilitating ...
... denials management, support documentation integrity as it pertains to accurate coding capture. The Regional Physician Advisor interfaces with hospital and medical staff leadership, facilitating ...
The On-Site Physician Advisor (OSPA) conducts timely and compliant medical necessity reviews and assists with denials management (facilitating and completing peer to peers, writing appeal letters) in ...
The On-Site Physician Advisor (OSPA) conducts timely and compliant medical necessity reviews and assists with denials management (facilitating and completing peer to peers, writing appeal letters) in ...
Lynchburg, VA · Remote
$41 - $56/hr
Prepares and distributes audit results/reports to Coding Management staff. Prepares and presents education to Inpatient coding staff based on audit findings and denials related to Inpatient coding ...
Lynchburg, VA · Remote
$41 - $56/hr
Prepares and distributes audit results/reports to Coding Management staff. Prepares and presents education to Inpatient coding staff based on audit findings and denials related to Inpatient coding ...
Lynchburg, VA · Remote
$41 - $56/hr
Prepares and distributes audit results/reports to Coding Management staff. Prepares and presents education to Inpatient coding staff based on audit findings and denials related to Inpatient coding ...
Lynchburg, VA · Remote
$41 - $56/hr
Prepares and distributes audit results/reports to Coding Management staff. Prepares and presents education to Inpatient coding staff based on audit findings and denials related to Inpatient coding ...
The Utilization Review Advisor (Advisor) position conducts timely and compliant medical necessity reviews and assists with denials management (facilitating and completing peer to peers, writing ...
The Utilization Review Advisor (Advisor) position conducts timely and compliant medical necessity reviews and assists with denials management (facilitating and completing peer to peers, writing ...
Broadway, VA · Remote
$64K - $97K/yr
Effectively communicate and educate relevant parties with the results of review/audit activity; and help with development of related action plans. * Assist with Denials Management to determine root ...
Broadway, VA · Remote
$64K - $97K/yr
Effectively communicate and educate relevant parties with the results of review/audit activity; and help with development of related action plans. * Assist with Denials Management to determine root ...
Williamsburg, VA · On-site
... denials management, support documentation integrity as it pertains to accurate coding capture. The Regional Physician Advisor interfaces with hospital and medical staff leadership, facilitating ...
Williamsburg, VA · On-site
... denials management, support documentation integrity as it pertains to accurate coding capture. The Regional Physician Advisor interfaces with hospital and medical staff leadership, facilitating ...
Norfolk, VA · On-site
... denials management, support documentation integrity as it pertains to accurate coding capture. The Regional Physician Advisor interfaces with hospital and medical staff leadership, facilitating ...
Norfolk, VA · On-site
... denials management, support documentation integrity as it pertains to accurate coding capture. The Regional Physician Advisor interfaces with hospital and medical staff leadership, facilitating ...
Norfolk, VA · On-site
$80 - $100/hr
This RN/PA/FMG/MD/HIM Professional responds to third party clinical denials, interfaces with health plans, works closely with Finance and Contracting regarding utilization management health plan ...
New
Norfolk, VA · On-site
$80 - $100/hr
This RN/PA/FMG/MD/HIM Professional responds to third party clinical denials, interfaces with health plans, works closely with Finance and Contracting regarding utilization management health plan ...
New
Richmond, VA · On-site
$20 - $35/hr
Communicate with co-workers, management, and hospital staff regarding clinical and reimbursement ... denials. Requires a strong understanding of coding guidelines and payer edits with the ability to ...
Richmond, VA · On-site
$20 - $35/hr
Communicate with co-workers, management, and hospital staff regarding clinical and reimbursement ... denials. Requires a strong understanding of coding guidelines and payer edits with the ability to ...
The Utilization Review Advisor (Advisor) position conducts timely and compliant medical necessity reviews and assists with denials management (facilitating and completing peer to peers, writing ...
The Utilization Review Advisor (Advisor) position conducts timely and compliant medical necessity reviews and assists with denials management (facilitating and completing peer to peers, writing ...
Lynchburg, VA · On-site
$125K - $201K/yr
... denials and accuracy of demographic and insurance information Audits clinical documentation for CPT/HCPCS coding Ensures accuracy of ICD-10 in the practice setting Manages the claims appeal process ...
Lynchburg, VA · On-site
$125K - $201K/yr
... denials and accuracy of demographic and insurance information Audits clinical documentation for CPT/HCPCS coding Ensures accuracy of ICD-10 in the practice setting Manages the claims appeal process ...
Lynchburg, VA · On-site
$125K - $201K/yr
... denials and accuracy of demographic and insurance information Audits clinical documentation for CPT/HCPCS coding Ensures accuracy of ICD-10 in the practice setting Manages the claims appeal process ...
Lynchburg, VA · On-site
$125K - $201K/yr
... denials and accuracy of demographic and insurance information Audits clinical documentation for CPT/HCPCS coding Ensures accuracy of ICD-10 in the practice setting Manages the claims appeal process ...
Identify and resolve denials and underpayments. Review contract management system to explain and resolve denials and arrange for payment or adjustment. Collaborates with other departments to obtain ...
Identify and resolve denials and underpayments. Review contract management system to explain and resolve denials and arrange for payment or adjustment. Collaborates with other departments to obtain ...
Identify and resolve denials and underpayments. Review contract management system to explain and resolve denials and arrange for payment or adjustment. Collaborates with other departments to obtain ...
Identify and resolve denials and underpayments. Review contract management system to explain and resolve denials and arrange for payment or adjustment. Collaborates with other departments to obtain ...
Lynchburg, VA · On-site
$125K - $201K/yr
... denials and accuracy of demographic and insurance information Audits clinical documentation for CPT/HCPCS coding Ensures accuracy of ICD-10 in the practice setting Manages the claims appeal process ...
Lynchburg, VA · On-site
$125K - $201K/yr
... denials and accuracy of demographic and insurance information Audits clinical documentation for CPT/HCPCS coding Ensures accuracy of ICD-10 in the practice setting Manages the claims appeal process ...
$12.63 - $15.36
8% of jobs
$17.18 is the 25th percentile. Wages below this are outliers.
$15.36 - $18.09
25% of jobs
The median wage is $20.17 / hr.
$18.09 - $20.82
22% of jobs
$20.82 - $23.55
15% of jobs
$24.79 is the 75th percentile. Wages above this are outliers.
$23.55 - $26.28
11% of jobs
$26.28 - $29.01
5% of jobs
$29.01 - $31.74
3% of jobs
$31.74 - $34.47
3% of jobs
$34.47 - $37.20
3% of jobs
$37.20 - $39.93
3% of jobs
$39.93 - $42.66
1% of jobs
$12
$23
$42
A Denials Management job involves analyzing and resolving rejected or denied insurance claims to ensure healthcare providers receive proper reimbursement. Professionals in this role investigate the reasons for claim denials, appeal when necessary, and work with insurance companies to correct errors or discrepancies. They also identify patterns in denials to implement process improvements and reduce future claim rejections. Strong knowledge of medical billing, insurance policies, and coding guidelines is essential for success in this role.
Professionals in Denials Management often encounter challenges such as navigating complex insurance policies, processing high volumes of claim denials, and keeping up with frequently changing payer requirements. Working in this role requires meticulous attention to detail and the ability to communicate effectively with both insurance companies and internal departments to resolve issues quickly. You may frequently collaborate with coding specialists, clinicians, and finance teams to gather documentation and appeal denials. Overcoming these challenges not only helps recover lost revenue but also improves overall workflow efficiency within the organization.
To succeed in Denials Management, you need expertise in medical billing, insurance claims processing, and healthcare regulations, often supported by a degree in healthcare administration or a related field. Familiarity with billing software, electronic health records (EHR) systems, and denial management platforms such as Epic or Cerner is highly beneficial. Strong analytical skills, attention to detail, effective communication, and persistence are essential soft skills for the role. These abilities are crucial to accurately review and resolve denied insurance claims, maximize revenue, and ensure compliance in a complex healthcare environment.
The most popular types of Denials Management jobs in Virginia are:
For Denials Management jobs in Virginia, the most frequently searched job titles are:
The top searched job categories for Denials Management jobs in Virginia are:
6.7
Based on 412 frontline employees who took The Breakroom Quiz
531st of 889 rated healthcare providers
Sentara Health is seeking to hire a qualified individual to join our team as Regional Physician Advisor.
Position Status : Full-time, Day Shift
Position Location: On-site.
Standard Working Hours : 8:00AM to 5:00PM (ET).
Sentara Health is seeking to hire a qualified individual to join our team as Regional Physician Advisor.
Expectations for this Role:
The Regional Physician Advisor supports the Clinical Revenue Cycle's Utilization Review and Denials/Appeals processes to determine and secure appropriate level of care assignments to ensure compliant billing, assist with denials management, support documentation integrity as it pertains to accurate coding capture. The Regional Physician Advisor interfaces with hospital and medical staff leadership, facilitating communication between Revenue Cycle leadership and processes and the hospital facilities and championing processes and initiatives. The Regional Physician Advisor assists with both formal and informal education of medical staff at Sentara hospital facilities. This role is responsible for supporting and meeting the Clinical Revenue Cycle functions organizational goals and objectives for assuring the effective, efficient utilization of health care services.
Requirements:
Completion of Medical doctorate or Doctor of Osteopathy degree from an accredited medical school
• Completion of an accredited residency training program
• Minimum of 5 years of clinical experience, hospital clinical experience strongly preferred
• Minimum of 2 years of physician advisory experience strongly preferred
• Active and unrestricted state Virginia medical license
• Board certification in specialty required at time of hire
• Posess or acquire a thorough understanding of CMS regulatory guidance and requirements as they pertain to UR and site of service decisions
• Possess a working knowledge of clinical documentation integrity, hospital billing and coding processes and guidelines, case mix index, and DRG assignments.
• Familiarity with standard published leveling criteria such as MCG/Interqual and ability to apply professional judgment and patient specific variables as may be necessary or justifiable.
• Familiarity with (Hospital) organization and case management operations
• Excellent customer service and interpersonal skills.
• Able to effectively present information, both formal and informal
• Superb written and verbal communications skills
• Strong organizational and analytic skills, and ability to set and manage priorities
• Demonstrate flexibility, teamwork, and a collaborative leadership style
• Strong technical/computer skills and working knowledge of the system's EMR
• Ability to provide a consistent on-site presence at assigned sites
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Hospitals
10,000+ Employees
Norfolk, VA, US
1888
