- Robert Half (Eden Prairie, MN)
- Description Clinical Appeals Representative (Contract - Fully Remote) We're seeking a detail-oriented Clinical Appeals Representative to join our team on ... health insurance operations by managing documentation, coordinating with providers, and ensuring appeals and grievances are processed accurately and on time. This is… more
- Humana (Raleigh, NC)
- …a team where your expertise truly makes an impact! As a Grievances & Appeals Representative , you'll be a go-to problem solver, turning complex challenges into ... the lives of those we serve. Reviews level 1 appeals cases and ensures that information is accurate. Forwards... cases and ensures that information is accurate. Forwards appeals to CMS entity for further review. Investigates and… more
- CVS Health (Indianapolis, IN)
- …Fluency in English and Spanish is required. Position Summary Customer Service Representative is the face of Aetna and impacts members' service experience by ... new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system. Educates providers on our self-ser-vice… more
- Guidehouse (San Marcos, CA)
- Job Family : Patient Account Representative Travel Required : None Clearance Required : None What You Will Do : The Insurance Patient Account Representative - ... days from home. Essential Job Functions Hospital Claims Account Review Appeals & Denials Medicare/Medicaid Insurance Follow-up Customer Service Billing UB-04 Duties… more
- Intermountain Health (Carson City, NV)
- …procedures such as debits/credits, required Experience with insurance claim appeals , required Excellent computer skills (including Microsoft Office applications), ... required- Familiarity with electronic remittances, required Physical Requirements Interact with others by effectively communicating, both orally and in writing Operate computers and other office equipment requiring the ability to move fingers and hands See and… more
- Northwell Health (Great Neck, NY)
- …Carries out clinical documentation requests to business office to ensure timely appeals . Implements policies and procedures to facilitate billing and maximize case ... collections. Implements improvements for financial management of each billing area. Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not… more
- WellSpan Health (York, PA)
- …account follow-up, researches claim denials for resolution and submits disputes and appeals when necessary. Represents the System in a professional manner while ... interacting with peers, leaders, patients, and third-party payers to achieve timely payment on accounts in accordance with current government and payer regulations. Duties and Responsibilities Essential Functions: Corrects financial and demographic information… more
- UnitedHealth Group (Dallas, TX)
- …for the accurate processing and completion of medical claim denials and appeals . Work according to Standard Operating Procedures. Proficiency in insurance standards ... and claims processing. Process correspondence and requests for reconsideration within standard timeframes. Write accurate and effective appeal letters to insurance companies on denied claims. Adhere to strict compliance standards. Demonstrate increasing… more
- Transdev (Readville, MA)
- …policies and procedures and regulations for accurate resolution of appeals , complaints, and grievances. Understand legal requirements and governmental reporting ... personnel so classified. The physical demands described here are representative of those that must be met by an...legally protected status. The physical demands described here are representative of those that must be met by an… more
- CBRE (San Francisco, CA)
- …of land, property, and businesses. What You'll Do: Ensure all property tax appeals are prosecuted timely and efficiently, completed accurately, and within the laws ... each crucial duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations… more
- Robert Half Accountemps (Eden Prairie, MN)
- Description Clinical Appeals Representative (Contract - Fully Remote) We're seeking a detail-oriented Clinical Appeals Representative to join our team on ... health insurance operations by managing documentation, coordinating with providers, and ensuring appeals and grievances are processed accurately and on time. This is… more
- Humana (Richmond, VA)
- …a team where your expertise truly makes an impact! As a Grievances & Appeals Representative , you'll be a go-to problem solver, turning complex challenges into ... lives of those we serve. + Reviews level 1 appeals cases and ensures that information is accurate. +...cases and ensures that information is accurate. + Forwards appeals to CMS entity for further review. + Investigates… more
- 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
- State of Colorado (Denver, CO)
- …review must be submitted on the official appeal form, signed by you or your representative . Appeals to the State Personnel Board or the State Personnel Director ... must be received or postmarked within the filing period: Appeals shall be filed with the Board no later...### Email filings: dpa_###@state.co.us For more information about the appeals process, the official appeal form, and how to… more
- 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 (Canton, MA)
- …(https://www.point32health.org/) . **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
- 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
- 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
- Healthfirst (FL)
- …through dismissal and complete verbal outreach attempts** + **Analyze incoming appeals and grievances to determine eligibility for dismissal based on Medicaid ... and adhere to the intricate, multi-step details of the Appointment of Representative (AOR) and Waiver of Liability (WOL) processes to ensure successful execution… more
- 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
Related Job Searches:
Appeals,
Claims Appeals Representative,
Claims Appeals Representative Data,
Denials Appeals Representative,
Grievance Appeals Representative,
Grievances Appeals Representative,
IRT Appeals Representative,
Representative,
Senior Appeals Representative,
Senior Claims Appeals Representative