- Cambia Health Solutions, Inc (Tacoma, WA)
- Appeals Specialist IRemote within WA, ID, OR, and UTPrimary Job Purpose:Responsible for all activities associated with requests for Provider Billing Disputes and ... Appeals . Includes analysis, preparation, evaluation of prior determinations, coordination of clinical review if needed, decision making, notification, and completion.… more
- Creative Financial Staffing (Cleveland, OH)
- Appeals Specialist About the company and Appeals Specialist opportunity: Our client is a law firm located in Cleveland, Ohio Hybrid 1 day per week Great health ... and tuition assistance Essential Duties and Responsibilities of the Appeals Specialist: Perform appeal edits and create appeals... Appeals Specialist: Perform appeal edits and create appeals in a variety of ebilling websites. Record all… more
- Creative Financial Staffing (Cleveland, OH)
- APPEALS SPECIALIST WHY YOU SHOULD BE THE APPEALS SPECIALIST Our client is a law firm located in Cleveland, Ohio Hybrid 1 day per week Great health benefits, ... Paid Maternity leave and tuition assistance RESPONSIBILITIES OF THE APPEALS SPECIALIST Perform appeal edits and create appeals... APPEALS SPECIALIST Perform appeal edits and create appeals in a variety of ebilling websites. Record all… more
- Accounting Now (Tampa, FL)
- Medicare Appeals Specialist Do you like challenging payers? Enjoy that feeling of satisfaction when your appeal is overturned? Then, this position may is right for ... you! The ideal candidate will be well versed in the Medicare managed care appeals and grievance process. Must have strong knowledge of Medicare payer guidelines and… more
- Accounting Now (Tampa, FL)
- …advanced-level work related to clinical and coding denial management and appeals follow-up. The individual is responsible for conducting a comprehensive review ... to compile appropriate documentation and medical records to submit appeals or corrected claims in a timely manner. This...fax, etc Documents and summarizes all rationale for all appeals in EPIC. Documents communications with medical office staff… more
- Preferred Solutions Group (Bethesda, MD)
- …the appropriateness of the release and review and make recommendations regarding appeals . . Review documents and responses to ensure compliance with the Acts ... Counsel in reviewing and arriving at recommendations regarding requests involving administrative appeals . . Review appeals for non-release of information or fees… more
- Option Care Health (Columbus, OH)
- …with Billing and Collection Training and completes "second level" appeals to payers.Job Description: Job Responsibilities:Submits timely, accurate invoices to ... payer for products and services provided. Understands the terms and fee schedule for all contracts for which invoices are submitted. Correctly determines quantities and prices for drugs billed. Verifies that the services and products are correctly authorized… more
- Blanchard Valley Health System (Findlay, OH)
- …of productivity to effectively reduce days in A/R. Develops and writes appeals for denials associated with the payment of claims within the department/division. ... Maintains appropriate timeliness of appeals for denials. Identifies other means and resources to...A/R and payer issues, avoid timely claim consideration/filing, failed appeals , and/or increased denials & write-offs. Participates in and… more
- Accounting Now (Pinellas Park, FL)
- …companies on unpaid insurance accounts identified through aging reportsAble to identify an appeals worthy claim and or ability to process appeals online or ... insurance accounts identified through aging reportsAble to identify an appeals worthy claim and or ability to process ...appeals worthy claim and or ability to process appeals online or via paper submission; Assist with billing… more
- US Tech Solutions, Inc. (Columbia, SC)
- …as needed to resolve inquiries. Reviews and adjudicates claims and/or non-medical appeals . Determines whether to return, deny or pay claims following organizational ... department guidelines. . Examines and processes claims and/or non-medical appeals according to business/contract regulations, internal standards and examining… more
- US Tech Solutions, Inc. (Atlanta, GA)
- …and/or resolve coverage requests. Escalate issues to Coverage Determinations and Appeals clinical pharmacists and management team as needed. Must maintain compliance ... resolve coverage requests. . Escalate issues to Coverage Determinations and Appeals clinical pharmacists and management team as needed. Must maintain compliance… more
- Penske Truck Leasing Co., LP (Reading, PA)
- …or manager with operating tax compliance processes including rendition/return filing, appeals and abatements and refund/bill entry. * Be able to understand ... or manager with operating tax compliance processes including rendition/return filing, appeals and abatements, bill entry for operating tax * Analyze processes,… more
- US Tech Solutions, Inc. (Atlanta, GA)
- …other internal groups regarding determination status and results (seniors, pharmacists, appeals , etc). . Identify and elevate clinical inquiries to the pharmacist ... team as appropriate . Other duties assigned, for example faxes, sorting, email boxes, CAS maintenance, etc. Experience: . 0 to 3 years of related work experience. Skills: . Prior Authorization . Call handling experience. Education: . High School diploma or GED… more
- George Washington University (Washington, DC)
- …software. Logs, tracks, and segments donors and donations for future appeals . Continuously seeks opportunities for improvement in financial practices and internal ... controls and implements new policies and procedures where appropriate to safeguard the Center's funds. Ensures existing policies and procedures are followed while ensuring optimum levels of internal controls. Maintains current listings on GuideStar and… more
- US Tech Solutions, Inc. (Columbia, SC)
- …of professional, inpatient or outpatient, facility benefits or services, and appeals . Documents decisions using indicated protocol sets or clinical guidelines. ... Provides support and review of medical claims and utilization practices. May provide any of the following in support of medical claims review and utilization review practices: Performs medical claim reviews and makes a reasonable charge payment determination.… more
- On Call Counsel (New York, NY)
- …settlement of special education claims.Prepare and argue difficult cases and appeals in administrative tribunals.Review, revise, and approve agreements prepared by ... other attorneys.Draft memoranda seeking fiscal settlement authority.Analyze the relative strength of impartial hearing cases and evaluate the appropriateness of plaintiffs' demands.Instruct appropriate offices regarding their obligations to parents and… more
- Cambia Health Solutions, Inc (Renton, WA)
- …reviews)Understanding of claims, billing and codingFacets/claims systems in appeals , SIUClaims processing, claims configuration rolesUnderstanding of Medical and ... reimbursement policiesCPC Certified or willing to get CPC Certified as condition to position.Normally to be proficient in the competencies listed belowPolicy and Implementation Analyst would have a Bachelor's degree in Business Administration or a related… more
- CornerStone Staffing (Dallas, TX)
- …the names of speakers and any technical terminology. Prepare transcripts for appeals or other future legal proceedings. Serve as liaison to lawyers, judges, ... or other local officials; providing information relating to court hearings and charges. Manage the commissions and creation of certificates of proceedings. Accept ownership for accomplishing new and different requests; explore opportunities to add value to job… more
- Creative Financial Staffing (Gaithersburg, MD)
- …in assembling supporting documentation for various tax and compliance audits and appeals . Support the financial reporting team in ad-hoc projects and financial ... analysis. Qualifications/Skills: Bachelor's degree in accounting, finance, or a related field. Proficient in Microsoft Office applications (Excel, Word, PowerPoint). Strong written and verbal communication skills. Critical thinking and problem-solving… more
- Axelon Services Corporation (Highland Beach, FL)
- …appropriate discharge plan, care plan, and coordination of acute care and long term care services * Assist member with filing and resolving complaints and appeals ... This position is member facing Job Description: Position Purpose: Responsible for members gaining access to needed services through coordination and integration of medical and long term care services for the purpose of orientation, care plan development,… more
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