- 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)
- …health care. The Coding Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all diagnosis and procedure codes to ... 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
- 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 ... payer, system or escalated account issues. + May maintain data tables for systems that support PB Claims... data tables for systems that support PB Claims operations. + Evaluate carrier and departmental information and… 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 - ... the review and assessment of completed compensation and pension claims . Duties include, but are not limited to: Performs...changes in procedures, regulations, or the law. Prepares STAR data reports and provides to personnel in the regional… 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
- Banner Health (AZ)
- …work options. Apply today, this could be the perfect opportunity for you. The Claims Follow Up Patient Financial Services Representative CBO will be working out ... activities in one or more assigned areas of billing, payment posting, collections, payor claims research, and other accounts receivable work. Works as a member of a… more
- US Anesthesia Partners (Austin, TX)
- …without a reasonable accommodation) + Contact s insurance companies for status on outstanding claims . + Process and follow up on appeals to insurance companies. ... Overview The Accounts Receivable Representative II is responsible for collecting outstanding accounts...of managed care, Medicare, and Medicaid guidelines . + Data entry skills with high accuracy . + Knowledge… more
- SSM Health (St. Louis, MO)
- …and payment rules. Bills claims appropriately. + Follows up on denied claims by performing appeals and denial recovery procedures. Works denied claim lines ... or more of the following: processing insurance payments, following up on denied claims , and resolving credit balances. May work in multiple functional areas. **Job… more
- SSM Health (Madison, WI)
- …and payment rules. Bills claims appropriately. + Follows up on denied claims by performing appeals and denial recovery procedures. Works denied claim lines ... or more of the following: processing insurance payments, following up on denied claims , and resolving credit balances. May work in multiple functional areas. **Job… more
- AssistRx (Overland Park, KS)
- …how to expedite patient access + Document and initiate prior authorization process and claims appeals + Report any reimbursement trends or delays in coverage to ... of our people and technology. We leverage advanced custom software, data analytics, and a patient-centered approach to transform medication management into… more
- CVS Health (Austin, TX)
- …excellent customer services for high volume in bound provider calls for the Claims Inquiry/ Claims Research team. Extensive claims research on multiple ... referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system . + Educates & assists… more
- PruittHealth (Norcross, GA)
- …timely payment. Responsible for contract analysis, reimbursement, denial management, appeals and resolving billing-related issues with insurance companies or other ... QA to insure accurate and timely creation of new claims and insures submitted claims meet payer...and deactivating old accounts as needed **Reporting** Reporting financial data , maintaining balance sheet schedules, and processing month end… more
- Robert Half Accountemps (Las Vegas, NV)
- …company systems to assist with customer needs, such as appointments, authorizations, claims , invoices, eligibility, benefits, and appeals + Accurately translate ... on enhancing health outcomes by connecting individuals with vital pharmacy benefits, data , and resources. Embrace a culture rooted in diversity and inclusion, with… more
- Priority Health Care (Marrero, LA)
- …include following up on claim status, billing and re-billing of claims , credit balance resolution, denial management, following up on aging accounts, ... insurance companies, using contract summaries to verify balances due on disputed claims , and coordinating payor denial and appeal follow-up activities. This also… more
- MyFlorida (Tallahassee, FL)
- …(relocation benefits are not available for this position) OPS Employment Security Representative II This position will be used for multiple vacancies OPEN ... The Work You Will Do: This is an OPS Employment Security Representative II- Employment Review Specialist position in the Department of Commerce's Reemployment… more
- MyFlorida (Fort Lauderdale, FL)
- …(relocation benefits are not available for this position) OPS Employment Security Representative II This position will be used for multiple vacancies. OPEN ... issues and the chargeability of employer accounts for benefit payments on claims . This may be accomplished telephonically, through written correspondence, or through… more
- MyFlorida (Orlando, FL)
- …(relocation benefits are not available for this position) OPS Employment Security Representative II This position will be used for multiple vacancies OPEN ... The Work You Will Do: This is an OPS Employment Security Representative II- Employment Review Specialist position in the Department of Commerce's Reemployment… more
- Keystone Lab (Asheville, NC)
- … claims , when necessary, after payer contact. + Ensure that goals set for claims , denials, suspensions, and appeals on aged accounts are met within the set ... to resolve within payer timely filing parameters. Prepare, review, and transmit claims using billing software, including electronic and paper claim processing. +… more
- State of Colorado (CO)
- …6000 classified positions including creation and maintenance of accurate payroll data ; on-board new staff; oversee employee relations, conflict resolution, and ... policy, State Personnel Board Rules, legal precedence, and DOC performance standards. Appeals & Legal Case- Requests for Information + Exercise discretion and… more