- Commonwealth of Pennsylvania (PA)
- …you will be responsible for the proper conduct of hearings and disposition of appeals for unemployment compensation (UC) claims in accordance with PA UC Law ... + Four years of experience in the determination of unemployment compensation claims , including adjustments, overpayments, and appeals supplemented by 6 college… more
- Point32Health (VA)
- …(https://youtu.be/S5I\_HgoecJQ) . **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Member Appeals and Grievance ... the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual works… more
- Guardian Life (Bethlehem, PA)
- Guardian is seeking individuals with Group Disability claims experience to join our dynamic Appeals Team. The ** Appeals Case Manager II** (ACM 2) is ... responsible for adjudicating assigned appeals for Group Life and Disability claims ....+ Complimentary 1:1 financial guidance with a licensed Fidelity representative **Time Off and Remote Work** + Flexible work… more
- Guardian Life (Bethlehem, PA)
- …& Litigation Support Specialist** will provide comprehensive assistance to the Group Claims Disability Appeals , Litigation and Complaints team. This role ... levels of supervision. You will + Monitor and triage appeals queues and assign work within established guidelines. +...3 years preferred experience in Group Disability and/or Life claims industry. + Strong verbal and written communication skills.… more
- St. Luke's University Health Network (Allentown, PA)
- …regardless of a patient's ability to pay for health care. The Coding Appeals Specialist retrospectively reviews patient medical records, claims data and coding ... AMA CPT, are assigned to support the services/treatment rendered. The Coding Appeals Specialist also prepares appeal arguments and/or letters to support and defend… more
- Texas Veterans Commission (San Benito, TX)
- …rulings, and state law in the adjudication process. . Prepares and files claims and appeals with supporting evidence for successful adjudication. . Advises ... Financial Operations* **Organization:** **TEXAS VETERANS COMMISSION* **Title:** *TVC - Claims Benefit Advisor (Veteran Services Representative I)* **Location:**… more
- Robert Half Accountemps (Novi, MI)
- Description We are in search of a Medical Claims Representative to join our team in NOVI, Michigan. This role is pivotal in the healthcare industry, providing a ... environment and contribute to ensuring a smooth and efficient process for medical claims . Responsibilities: * Initiate and manage claims from clients, ensuring… more
- Robert Half Accountemps (Fort Wayne, IN)
- …This role is in the healthcare industry and will involve follow-ups on medical claims . The workplace environment is business casual and requires a high level of ... interaction with doctor offices. Responsibilities: * Follow-up on insurance claims and patient claims payments. * Provide customer service in relation to medical… more
- Guidehouse (El Segundo, CA)
- …Chris Rivera (Manager, Talent Acquisition) at ###_** **Essential Job Functions** + Hospital Claims + Account Review + Appeals & Denials + Medicare/Medicaid + ... **Job Family** **:** Patient Account Representative **Travel Required** **:** None **Clearance Required** **:**...+ 1+ year's medical provider experience working with UB04, appeals & denials. + Hospital or EOB claims… more
- Guidehouse (Lewisville, TX)
- **Job Family** **:** Patient Account Representative **Travel Required** **:** None **Clearance Required** **:** None **What You Will Do** **:** The Patient Account ... Representative (PAR) is expected to perform specific billing processes,...taking necessary actions to obtain account resolution + Submits appeals , as appropriate, for all non-clinical denials + Monitors… more
- Guidehouse (San Antonio, TX)
- **Job Family** **:** Patient Account Representative **Travel Required** **:** None **Clearance Required** **:** None **What You Will Do** **:** The Patient Account ... Representative is an extension of a client's business office...clients: 1+ year medical provider experience working with UB04, appeals & denials. + PC skills in a Windows… more
- Veterans Benefits Administration (Huntington, WV)
- …well as taking claims and assisting claimants in the preparation of claims , appeals or other documents. Delegates authority to make decisions including ... Summary The Supervisory Veterans Service Representative - Assistant Veterans Service Center Manager (AVSCM)...and pension benefits to provide guidance and direction on claims and appeals processing. Supervised, managed, or… more
- Houston Methodist (Houston, TX)
- …functions, including claims resubmission to payors. + Creates and submits appeals when necessary. Engages the coding follow-up team for any medical necessity or ... At Houston Methodist, the Account Representative position is responsible for resolving all outstanding third party primary and secondary insurance claims for… more
- Surgery Care Affiliates (Boise, ID)
- …the growing career opportunities for YOU. Responsibilities The Patient Account Representative will be responsible for thorough and timely patient account follow ... and after procedures. + Works all denials and corrected claims collaborating with the biller and/or Business Office Manager,...experience in a medical office as a patient account representative . + Candidate MUST HAVE knowledge of medical billing,… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- …revenue agencies and other healthcare providers with member benefits, eligibility, claims inquiry, claim reconsiderations and appeals . The Customer Service ... + Handle inbound calls from members, medical providers, and others. + Adjust claims accurately, if needed. + Listen to and address customer needs and concerns… more
- Sanford Health (Fargo, ND)
- …you would like. Once trained, flexible hours. **Job Summary** The Insurance Representative processes and monitors unpaid third party insurance, Medicare, Medicaid or ... to work accounts throughout the entire revenue cycle. Prepares and submits claims to payers either electronically or by paper. Secures necessary medical… more
- UNC Health Care (Chapel Hill, NC)
- …and philosophy. Responsibilities: + Responsible for the accurate and timely submission of claims follow up, reconsideration and appeals , response to denials, and ... a variety of complex duties, including but not limited to, working outstanding insurance claims follow up for no response from payors, and/or claim denials. + Works… more
- Guidehouse (Birmingham, AL)
- **Job Family** **:** Patient Account Representative **Travel Required** **:** None **Clearance Required** **:** None **What You Will Do** **:** The Central Denials ... Account Representative conducts thorough account reviews to determine the appropriate...resolve claim denials and account balances. + Performing Non-Clinical Appeals . + Assisting Supervisor/Manager as needed with various projects.… more
- Access Dubuque (Dubuque, IA)
- …FT Days MercyOne Registered Nurse - Psychiatric Services - FT Night MercyOne Claims Processing Representative Grand River Medical Group Dining Services Assistant ... Member Services Representative **Medical Associates** 1 Positions ID: oXDJufwx Posted...department; possess knowledge to examine, process, calculate and administer claims according to internal processing guidelines. + Assist in… more
- WellSpan Health (York, PA)
- Patient Financial Services Representative I - Patient Financial Servcies - Day Location: WellSpan Health, York, PA Schedule: Part Time General Summary Completes ... Assists in the completion of submitting electronic and/or manual insurance claims , resolves claim edits, performs insurance account follow-up, researches claim… more