- Rady Children's Hospital San Diego (San Diego, CA)
- …claim submission. This position is responsible for pulling medical records to submit with claims and appeals as required by payors. Responsible to validate and ... incumbent completes daily processing of claim edits or rejected claims processed through the billing system and from electronic...accurately complete the claims identified with potential new payor plan coverage added… 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 ... customer service experience. + 2 - 4 years of grievance and/or appeals experience. + Previous experience processing medical claims . **Additional Information**… 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
- St. Luke's University Health Network (Allentown, PA)
- …of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding ... determination made by the government or commercial payors, or their auditor representative . + Facilitate clinical chart reviews to assist with supporting assigned… 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 ... **Job Duties** + Review and analyze denied or underpaid claims to determine appeal opportunities. + Prepare and submit...staff and coding teams to obtain necessary documentation for appeals + Track and monitor appeal status, maintaining detailed… more
- Texas Veterans Commission (Victoria, TX)
- …rulings, and state law in the adjudication process. . Prepares and files claims and appeals with supporting evidence for successful adjudication. . Advises ... Financial Operations* **Organization:** **TEXAS VETERANS COMMISSION* **Title:** *TVC - Claims Benefit Advisor (Veterans Services Representative I)* **Location:**… more
- Guidehouse (El Segundo, CA)
- …Required** **:** None **What You Will Do** **:** The **Insurance Patient Account Representative ** **(Hospital Claims )** is an extension of a client's business ... and three days from home._** **Essential Job Functions** + Account Review + Appeals & Denials + Medicare/Medicaid + Insurance Follow-up + Customer Service + Billing… more
- Kelly Services (Myrtle Beach, SC)
- …Great opportunities are right here in your backyard. Kelly(R) is looking for a Claims Customer Service Representative to work at a premier organization in Myrtle ... - $23 Why you should apply to be a Claims Customer Service Representative : + Competitive pay...written, web, or walk-in inquiries. + Reviewing and adjudicating claims and/or non-medical appeals , determining whether to… more
- TEKsystems (Farmington, CT)
- Insurance Follow‑Up Representative (Hybrid) Shift: 7:30 am - 4:00 pm Employment Type: Full-Time Schedule: Monday - Friday Pay Rate: $25-27/HR Hybrid Schedule (After ... A leading academic health system is seeking an experienced Insurance Follow‑Up Representative to support its hospital billing operations. This role focuses on… more
- Beth Israel Lahey Health (Charlestown, MA)
- …reviews, and interprets third party payments, adjustments, and denials. Initiates corrected claims , appeals and analyzes unresolved third party and self-pay ... 17. Assists the Supervisor, Billing with the resolution of complex claims issues, denials, appeals and credits. 18. Completes projects and research as assigned.… more
- Guidehouse (San Marcos, CA)
- …San Marcos office and three days from home._** **Essential Job Functions** + Hospital Claims + Account Review + Appeals & Denials + Medicare/Medicaid + Insurance ... **Job Family** **:** Patient Account Representative **Travel Required** **:** None **Clearance Required** **:**...+ 1+ year's medical provider experience working with UB04, appeals & denials. + Hospital or EOB claims… more
- Banner Health (Phoenix, AZ)
- …settings by including remote and hybrid opportunities. As a **Provider Experience Representative ** for Banner Plans & Networks you will take inbound calls answering ... will call upon your **background in medical billing, medical claims , customer service, and managed care** to answer complex...goal of first call resolution. As a **Provider Experience Representative ** , you will be working in a hybrid/remote… more
- Reno Orthopedic Center (Reno, NV)
- Reno Orthopedic Center wants you to join the team as a Patient Billing Representative ! We are seeking an enthusiastic and dedicated team member to communicate with ... with patients and insurance companies to gather status updates, appeal claims , resolve outstanding patient balances, and obtain information related to billing… more
- Rochester Regional Health (Rochester, NY)
- JOB TITLE: Collections and Denials Management Representative LOCATION: SLH DEPARTMENT: Patient Financial Services Hours: 37.5 SCHEDULE: Monday-Friday 8AM-4PM ... Billing and Denials Specialist is responsible for managing the billing process, submitting claims to insurance companies, following up on unpaid or denied claims… more
- 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 ... of health care complaints, including, but not limited to billing and claims reimbursement disputes; denials of coverage for medical treatment, prescriptions, and… more
- Cardinal Health (Doral, FL)
- …Collector is responsible for the timely follow-up and resolution of insurance claims . This role ensures accurate and efficient collection of outstanding balances ... escalate issues. + Analyze denials and underpayments to determine appropriate action ( appeals , corrections, resubmissions). + Track and follow up on all submitted … more
- Access Dubuque (Dubuque, IA)
- …time MercyOne Bilingual Member Services Coordinator Cottingham & Butler/ SISCO Claims Representative Cottingham & Butler/ SISCO Service Representative ... Customer Service Representative **Medical Associates** 1 Positions ID: ok7YyfwH Posted...issues. Handling EOB's, submitting physician notes for protests and appeals , resubmitting corrected HCFA's, protesting denials and follow-up to… more
- University of Rochester (Rochester, NY)
- …to successful closure and obtain maximum revenue collection. Researches, corrects, resubmits claims , submits appeals and takes timely and routine action to ... resolve unpaid claims . Mentors and trains new or lower level staff....about prompt account resolution and revenue collection from complex claims , high dollar claims , and specialized services.… more
- SSM Health (Madison, WI)
- …and payment rules. Bills claims appropriately. + Follows up on denied claims by performing appeals and denial recovery procedures. Works denied claim lines ... the following: processing insurance payments, following up on denied claims , and resolving credit balances. May work in multiple...and no response claims to resolve outstanding accounts. + Analyzes credit balances… more
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