• Clinical Appeals Representative

    Robert Half Office Team (Minneapolis, MN)
    …you looking for a rewarding remote role in healthcare administration? This Clinical Appeals Representative position offers the opportunity to make a meaningful ... impact while working from the comfort of your home. As a Clinical Appeals Representative , you will play a key role in managing the intake and processing of… more
    Robert Half Office Team (12/05/25)
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  • Appeals and Grievance Analyst

    Point32Health (FL)
    …(https://www.point32health.org/) . **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Appeals and Grievance Analyst ... the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual works… more
    Point32Health (12/23/25)
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  • Appeals and Grievance Analyst

    Point32Health (MA)
    …. **Job Summary** SUMMARY Under the general direction of the Member Appeals and Grievance Supervisor the Member Appeals and Grievance Analyst ... the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual works… more
    Point32Health (12/23/25)
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  • DD Waiver Enrollment & Appeals Specialist

    State of Colorado (Denver, CO)
    DD Waiver Enrollment & Appeals Specialist Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5159953) Apply  DD Waiver Enrollment & Appeals ... Colorado. We are looking for aDD Waiver Enrollment & Appeals Specialist to join our Office Of Community Living...the official appeal form signed by you or your representative . This form must be completed and delivered to… more
    State of Colorado (12/24/25)
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  • Appeals & Grievance Case Resolution…

    AmeriHealth Caritas (Philadelphia, PA)
    …. **This position is hybrid in Philadelphia, PA** **Job Summary** The Appeals & Grievance Case Resolution Specialist is responsible for the full life ... cycle of assigned member and/or provider appeals and grievance cases. Working under general supervision, this role conducts case intake, investigation, and… more
    AmeriHealth Caritas (12/24/25)
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  • RN Clinical Review Appeals Specialist…

    St. Luke's University Health Network (Allentown, PA)
    …a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all ... determination made by the government or commercial payors, or their auditor representative . + Facilitate clinical chart reviews to assist with supporting assigned… more
    St. Luke's University Health Network (10/28/25)
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  • Senior Financial Analyst - Specialized…

    Ochsner Health (New Orleans, LA)
    …make a difference at Ochsner Health and discover your future today!** The Appeals Specialist is responsible for managing and resolving insurance claim denials and ... staff and coding teams to obtain necessary documentation for appeals + Track and monitor appeal status, maintaining detailed...and Environmental Demands** The physical demands described here are representative of those that must be met by an… more
    Ochsner Health (10/11/25)
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  • Human Resources Specialist 1 (Labor Relations),…

    New York State Civil Service (Albany, NY)
    …Review and conduct agency level panel meetings associated with performance evaluation appeals as a representative of the employer;* Support the Bureau ... unemployment insurance claims and appear at any associated hearings as a representative of the employer; and* Complete special projects as assigned. Minimum… more
    New York State Civil Service (12/24/25)
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  • Bilingual Immigration Coordinator - Spanish…

    HANAC, Inc. (Astoria, NY)
    …integral part of a team with the immigration attorney, Board of Immigration Appeals (BIA) accredited representative , and support staff. The Immigration Paralegal ... will assist the staff attorney and the Program Director in providing legal services, education, and outreach, including coordination of community events, and working under attorney supervision to assist clients on Immigration law matters. The Paralegal will… more
    HANAC, Inc. (11/07/25)
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  • Veteran's Services Representative

    Mendocino County Sheriff's Office (Ukiah, CA)
    Veteran's Services Representative Print (https://www.governmentjobs.com/careers/mendocinoca/jobs/newprint/5169641) Apply  Veteran's Services Representative ... full-time, and part-time positions, should they occur. The Veterans Services Representative provides essential support and assistance to veterans and their… more
    Mendocino County Sheriff's Office (12/16/25)
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  • PFS Representative Billing and Collecting

    Whidbey General Hospital (Coupeville, WA)
    JOB SUMMARY The Patient Financial Services Representative supports the mission of providing quality healthcare to the patients of WhidbeyHealth by performing a ... support the financial health and well-being of the organization. The PFS Representative may be responsible for coordinating patient referrals and subsequent follow… more
    Whidbey General Hospital (01/01/26)
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  • Central Denials Account Representative

    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
    Guidehouse (12/20/25)
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  • Patient Account Representative - Hospital…

    Guidehouse (San Marcos, CA)
    **Job Family** **:** Patient Account Representative **Travel Required** **:** None **Clearance Required** **:** None **What You Will Do** **:** The **Insurance ... Patient Account Representative - Hospital A/R Emphasis** is an extension of...Job Functions** + Hospital Claims + Account Review + Appeals & Denials + Medicare/Medicaid + Insurance Follow-up +… more
    Guidehouse (11/16/25)
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  • Prosthetic Representative (Service Chief)

    Veterans Affairs, Veterans Health Administration (Beckley, WV)
    …of an assigned area to include budget execution. Serve as contract officer representative (COR) for PSAS contracts. Develop statements of work for service contracts ... tools that allow monitoring of a quality assurance program, etc. Processes Veteran appeals and responses. Ability to deal effectively with individuals and groups and… more
    Veterans Affairs, Veterans Health Administration (12/30/25)
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  • Senior Consumer Frauds Representative

    New York State Civil Service (Albany, NY)
    …Yes Agency Attorney General, Office of the Title Senior Consumer Frauds Representative or Consumer Frauds Representative Trainee (NY HELPS) Occupational Category ... their legal rights, advises them of complaint filing procedures, assist with appeals /grievances, or refers them to other government or private agencies. * Appraises… more
    New York State Civil Service (12/25/25)
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  • Patient Account Representative - Physician…

    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 (12/19/25)
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  • Case Management Representative

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Case Management Representative position is responsible for providing clerical assistance and data management support to the case management ... securing signatures on the form from the patient or their legal representative , and answering questions regarding the appeal process + Distributes the Medicare… more
    Houston Methodist (11/08/25)
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  • Patient Services Representative

    Corewell Health (Grand Rapids, MI)
    …working every Sunday, Tuesday, and Thursday. Job Summary As a Patient Services Representative with Corewell Health, you'll play a vital role in delivering top-notch ... that prior authorization has been obtained; assists with retroactive insurance denials/ appeals . + Responsible for complex EMR/EHR scanning and Right Fax faxing… more
    Corewell Health (12/31/25)
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  • Provider Experience Representative Banner…

    Banner Health (Tucson, AZ)
    …settings by including remote and hybrid opportunities. As a **Provider Experience Representative ** for Banner Plans & Networks you will take inbound calls answering ... and satisfaction with a goal of first call resolution. As a **Provider Experience Representative ** , you will be working in a hybrid/remote setting. Your work shifts… more
    Banner Health (12/31/25)
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  • Patient Accounts Representative II

    BJC HealthCare (St. Louis, MO)
    …**Additional Information About the Role** BJC HealthCare is seeking a Patient Accounts Representative to assist with physican billing follow up. Duties for this role ... include working claims, contacting payors, and filing appeals in hopes to get payment on claims. **Overview**...the country. **Preferred Qualifications** **Role Purpose** The Patient Accounts Representative II serves as a subject matter expert in… more
    BJC HealthCare (12/23/25)
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