- Daiichi Sankyo, Inc. (Seattle, WA)
- …pharmaceutical therapies to improve standards of care and address diversified, unmet medical needs of people globally by leveraging our world-class science and ... purpose of this role is to serve as a field-based, product access specialist that provides appropriate reimbursement support to HCPs to help facilitate patient… more
- Daiichi Sankyo, Inc. (Boston, MA)
- …pharmaceutical therapies to improve standards of care and address diversified, unmet medical needs of people globally by leveraging our world-class science and ... purpose of this role is to serve as a field-based product access specialist that provides appropriate reimbursement support to HCPs to help facilitate patient access… more
- Accounting Now (Tampa, FL)
- …Clinical Denials Nurses and Coding Denials Specialists to compile appropriate documentation and medical records to submit appeals or corrected claims in a timely ... The Denials Specialist performs advanced-level work related to clinical and...fax, etc Documents and summarizes all rationale for all appeals in EPICDocuments communications with medical office… more
- Blanchard Valley Health System (Findlay, OH)
- PURPOSE OF THIS POSITION The Denial Management Specialist is responsible for the timely review and accurate identification and follow-up of all initial denial ... as the appeal of denials/rejections from third-party payers. The specialist will manage their assigned work relating to all...to effectively reduce days in A/R. Develops and writes appeals for denials associated with the payment of claims… more
- US Tech Solutions, Inc. (Columbia, SC)
- …needed to resolve inquiries. . Reviews and adjudicates complex or specialty claims and/or non- medical appeals . . Determines whether to return, deny or pay claims ... of response or extensive research. . Examines and processes claims and/or non- medical appeals according to business/contract regulations, internal standards and… more
- Spectraforce Technologies Inc (Atlanta, GA)
- Title: Patient Access Specialist Location: Remote Duration: 3+ month's Shift timings: 8:00 am - 8:00 pm EST Job Details: Complete data entry from the enrollment form ... Under the general supervision of an Operations Manager, the Customer Access Specialist will be providing advanced services to patients, providers, and caregivers on… more
- Dialysis Clinic, Inc. (Sacramento, CA)
- …with a lower caregiver-to-patient ratio than other providers.The AR Specialist will provide continual and accurate documentation regarding eligibility, ... accuracy as well as sending out initial claims, corrected claims and appeals .Starting pay: $23.00/hr. This position is for the California / NM… more
- Northeast Georgia Health System, Inc (Oakwood, GA)
- …of Protected Health InformationAbility to manage changeExtensive knowledge of medical terminology Must possess detailed understanding and knowledge of insurance ... and interprets clinical information submitted from the Physician, emphasizing the medical justification for a procedure, in order for completion of the… more
- Accounting Now (Pinellas Park, FL)
- … Billing and Collections Specialists in St Petersburg, Florida. Billing & Collections Specialist The medical billing and collection specialist is responsible ... Medicaid, Medicaid Managed Care, and commercial insurance payers. The medical billing and collection specialist must possess...appeal claims if needed and or ability to process appeals online or via paper submission; Assist with billing… more
- Compass Health Network (St. Charles, MO)
- …interest you, if running a Medication Clinic and acting as a case manager appeals to you! Our Compass Health Network Nursing Staff use the Compass "Champion" ... clientele. This role will actively communicate with their Clinical Doctor and Customer Relations Specialist to ensure our clients are taken care of. This is a full… more
- Compass Health Network (St. Charles, MO)
- …interest you, if running a Medication Clinic and acting as a case manager appeals to you! Our Compass Health Network Nursing Staff use the Compass "Champion" ... actively communicate with their Clinical Doctor and Customer Relations Specialist to ensure our clients are taken care of....cleanliness of unit facilities and equipment Monitor supply of medical stock, medical supplies, and laboratory needs… more
- University of Utah (Salt Lake City, UT)
- …**Requisition Number** PRN39530B **Job Title** Outpatient/Provider Coder Level 3 **Working Title** Medical Appeals Coding Specialist SR **Job Grade** E ... of U Health - Academics **Department** 00209 - Univ Medical Billing - Oper **Location** Other **City** Other **Type...-H), Certified Professional Coder-Payer ( CPC -P), Certified Coding Specialist ( CCS ), Certified Coding Specialist … more
- TEKsystems (Addison, TX)
- …medical necessity, and reimbursement methodologies to strengthen appeal arguments. Skills: Appeals , Claim, medical collections, Medical insurance, TDI, ... NSA, commercial insurance, out of network Top Skills Details: Appeals ,Claim, medical collections, Medical insurance #PriorityCentral About TEKsystems: We're… more
- CDPHP (Albany, NY)
- …accreditation and other regulatory requirements. Using knowledge of clinical nursing and medical practices, the Clinical Appeals Specialist will review ... values and invites you to be a part of that experience. The Clinical Appeals Specialist is responsible for adhering to a member/provider appeal and grievance… more
- Sutter Health (Modesto, CA)
- **Organization:** MMC-Memorial Medical Center **Position Overview:** The Grievances & Appeals Specialist supports the patient and family experience through ... and Risk Management Services is required on a frequent basis for complex medical legal issues. Assists staff members who request intervention in diffusing difficult… more
- Martin's Point Health Care (Portland, ME)
- …and external customers + Cross-trains to perform either Medicare or USFHP Appeals Specialist functions as needed Education/Experience: + Bachelor's Degree or ... provider pre- and post-service appeals , and participating provider pre-service appeals . The Specialists collaborates with Care Managers, Medical Directors… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, ... net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Nurse Specialist RN II Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, ... net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Nurse Specialist Registered Nurse (RN) II provides… more
- Carle (Urbana, IL)
- Outpatient Denial/ Appeals Specialist - RN + Department: Revenue Cycle - CFH_10_19 + Entity: Champaign-Urbana Service Area + Job Category: Clerical/Admin + ... Carle enterprise. Represents Carle in clinical meetings and writing appeals on outpatient accounts where medical necessity,...and writing appeals on outpatient accounts where medical necessity, level of care or prior authorization is… more
- Insight Global (Los Angeles, CA)
- Job Description The Customer Solution Center Appeals and Grievances Specialist I will support the Appeals and Grievances team to receive, investigate and ... resolve member and provider complaints and appeals ; escalate complex issues or questions to leadership team...(DHCS), Department of Managed Health Care (DMHC), Managed Risk Medical Insurance Board (MRMIB) and National Committee for Quality… more
