- NJM Insurance (Hammonton, NJ)
- NJM's General Claims Legal Department is currently seeking to fill a PIP Appeals and Litigation (PAL) Representative position. We are looking for talent who ... attend legal proceedings as appropriate* Collaborate and communicate cross-departmentally regarding claims and appeals handling related to pending litigation… more
- HCA Healthcare (Nashville, TN)
- …scrubbing/edits, vendor edit challenges/disputes and post bill processes for efficient claims resolution, including effective appeals for select inventory. This ... **Description** **Job Summary and Qualifications** The Coding Operations Education and Appeals Consultant is responsible for assisting in the efficient and effective… 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 (Amarillo, 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
- State of Indiana (Indianapolis, IN)
- …for protested claims . + Determine exhibits to be offered during appeals hears and defend determinations. + Receive, investigate, and correct system error list ... Claims Investigator Date Posted: Nov 13, 2024 Requisition...accessible, and equitable workplace with a workforce that is representative of Indiana's population. As a proud equal opportunity… more
- Independent Health (Buffalo, NY)
- …and commitment to diversity and inclusion. **Overview** The Provider Relations Representative is responsible for assisting our provider constituents and providing ... exceptional customer service. The Provider Relations Representative will answer incoming calls from health care providers including physician offices, ancillary… more
- WellSpan Health (York, PA)
- Patient Financial Services Representative II - Govt Billing - Days Location: WellSpan Health, York, PA Schedule: Full Time General Summary Completes assigned revenue ... Cycle functions including, submitting electronic and / or manual insurance claims , resolves claim edits, performs insurance account follow-up, researches claim… 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
- TEKsystems (Nashville, TN)
- …AR accounts for a multi-physician Oncology practice. Including processing insurance claims , reviewing EOB'S, submitting appeals , follow up with insurance ... Billing. They must be able to explain the process of appeals and denials, corrected claims , EOB'S. Preferred to have minimum 3-4 years experience within medical… 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
- Insight Global (Norfolk, VA)
- Job Description We are seeking a dedicated Healthcare Customer Service Representative to join our team. This role involves assisting members with inquiries related ... to their insurance plans, eligibility, benefits, and claims . The ideal candidate will have a strong understanding...with members and assist with EOB inquiries. Grievance and Appeals Initiate grievance and appeals requests over… 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
- Veterans Benefits Administration (St. Petersburg, FL)
- …by Compensation Service and/or the Pension and Fiduciary Service and the Court of Appeals for Veterans Claims are met or implemented. Work Schedule: Monday - ... needs through the review and assessment of completed compensation and pension claims . Duties include, but are not limited to: Performs individual quality reviews… more
- Veterans Benefits Administration (Louisville, KY)
- …of C&P laws and regulations, to include precedent opinions of the Court of Appeals for Veterans' Claims and authoritative opinions of the General Counsel. ... District Regional Offices located in Louisville, KY. The Supervisory Veterans Service Representative (Assistant Coach) is an integral part of VSC, BEST, or PMC… more