• 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
    JobGet (08/25/24)
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  • 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
    JobGet (08/25/24)
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  • Compass Health Network (Raymore, 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" ... This role will actively communicate with their Clinical Doctor and Customer Relations Specialist to ensure our clients are taken care of. An Outpatient Nurse will… more
    JobGet (08/27/24)
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  • Compass Health Network (Raymore, 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" ... This role will actively communicate with their Clinical Doctor and Customer Relations Specialist to ensure our clients are taken care of. An Outpatient Nurse will… more
    JobGet (08/27/24)
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  • 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
    JobGet (08/25/24)
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  • 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
    JobGet (08/25/24)
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  • Compass Health Network (St. Louis, 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" ... This role will actively communicate with their Clinical Doctor and Customer Relations Specialist to ensure our clients are taken care of. An Outpatient Nurse will… more
    JobGet (08/25/24)
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  • Compass Health Network (Arnold, 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" ... This role will actively communicate with their Clinical Doctor and Customer Relations Specialist to ensure our clients are taken care of. An Outpatient Nurse will… more
    JobGet (08/25/24)
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  • Compass Health Network (Arnold, 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" ... This role will actively communicate with their Clinical Doctor and Customer Relations Specialist to ensure our clients are taken care of. An Outpatient Nurse will… more
    JobGet (08/25/24)
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  • Appeals Specialist II

    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 ... other internal and external partners to ensure a comprehensive appeals management process. Job Description Specialist II...a comprehensive appeals management process. Job Description Specialist II Key Outcomes: + Serves as daily resource… more
    Martin's Point Health Care (08/27/24)
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  • Outpatient Denial/ Appeals

    Carle (Urbana, IL)
    Outpatient Denial/ Appeals Specialist - RN + Department: Revenue Cycle - CFH_10_19 + Entity: Champaign-Urbana Service Area + Job Category: Clerical/Admin + ... documentation review to establish and manage clinical and prior authorization denial appeals for the Carle enterprise. Represents Carle in clinical meetings and… more
    Carle (08/23/24)
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  • Clinical Appeals Specialist

    CDPHP (Albany, NY)
    …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 ... Using knowledge of clinical nursing and medical practices, the Clinical Appeals Specialist will review medical necessity requests, render determinations… more
    CDPHP (07/27/24)
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  • Appeals Specialist

    TEKsystems (Memphis, TN)
    Revenue Cycle/ Appeals Specialist Needed Description: 100% Remote Equipment Provided The Appeals Specialist 1, under the direction of the Director of ... processes. Skills: medical claims processing, insurance claim, insurance collections, appeals , revenue cycle Additional Skills & Qualifications: -2 years of… more
    TEKsystems (08/26/24)
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  • Grievance & Appeals Specialist

    Sutter Health (Modesto, CA)
    **Organization:** MMC-Memorial Medical Center **Position Overview:** The Grievances & Appeals Specialist supports the patient and family experience through the ... investigation of patient/family complaints, concerns, and other feedback received by the organizations. Complaints and grievances include, but are not limited to, the care provided by physicians and other health care professionals, potential liability, quality… more
    Sutter Health (08/30/24)
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  • Medical Appeals Coding Specialist SR

    University of Utah (Salt Lake City, UT)
    …Number** PRN39530B **Job Title** Outpatient/Provider Coder Level 3 **Working Title** Medical Appeals Coding Specialist SR **Job Grade** E **FLSA Code** Nonexempt ... Coder-Hospital ( CPC -H), Certified Professional Coder-Payer ( CPC -P), Certified Coding Specialist ( CCS ), Certified Coding Specialist - Physician Based (… more
    University of Utah (08/15/24)
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  • Appeals & Compliance Specialist

    Area Agency On Aging 1-b (Southfield, MI)
    The Appeals and Compliance Specialist is responsible for providing comprehensive responses in compliance with contract, regulatory and accreditation requirements ... information and communicate disposition of case . + Triages case inquiries, appeals , and prepares case files/packets for appeal hearings. Attend State Fair Hearings… more
    Area Agency On Aging 1-b (07/21/24)
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  • Appeals & Grievance Specialist

    Baylor Scott & White Health (Temple, TX)
    **JOB SUMMARY** The Appeals and Grievance Specialist performs reviews, within operational aspects, of the member and provider complaints, appeals and ... of cases; review, research and coordination of complaints, grievances, appeals and reconsiderations consistent with statutory and federal regulatory guidelines.… more
    Baylor Scott & White Health (07/19/24)
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  • Appeals & Grievances Specialist I

    Generac Power Systems (Waukesha, WI)
    …into an energy technology solutions company, we continue to push new boundaries. The ** Appeals and Grievances Specialist ** is a critical team player who is ... under general supervision with some guidance from leadership and higher-level Appeals and Grievances Specialists. **Job Responsibilities:** Case Resolution + Handles… more
    Generac Power Systems (07/17/24)
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  • Customer Solution Center Appeals

    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, ... achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will...Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve member and… more
    LA Care Health Plan (08/02/24)
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  • Appeals and Grievances Specialist II

    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...of this role is to learn the specialty level appeals and grievances work by resolving less complex cases… more
    Insight Global (08/16/24)
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