- The Cigna Group (Bloomfield, CT)
- …of all supporting documents to determine how to correctly enter the appeal data in the appropriate data system. Proactively communicates with appellants, ... limited to:** + Ability to differentiate different types of requests Appeals , Grievances, coverage determination and Organization Determinations in order to ensure… more
- Catholic Health Services (Melville, NY)
- …Catholic Health was named Long Island's Top Workplace! Job Details The Appeals and Authorization representative will perform activities to resolve authorization ... to the practices detailing total denials and status on appeals . Prepare appeals for claims ...issues that are contributing to authorization denials. Track all data sent to practices and maintain a schedule for… more
- UNC Health Care (Chapel Hill, NC)
- …and philosophy. Responsibilities: + Responsible for the accurate and timely submission of claims follow up, reconsideration and appeals , response to denials, and ... payer, system or escalated account issues. + May maintain data tables for systems that support PB Claims... data tables for systems that support PB Claims operations. + Evaluate carrier and departmental information and… more
- Virtua Health (Mount Laurel, NJ)
- …on assigned insurances on a monthly basis and maintains records of declined claims requiring appeals . Position Qualifications Required / Experience Required: 1-3 ... codes, insurance information) and enters into database. Identifies and resolves denied claims , escalating accounts as necessary to ensure timely payment of claims… more
- Banner Health (AZ)
- …work options. Apply today, this could be the perfect opportunity for you. The Claims Follow Up Patient Financial Services Representative CBO will be working out ... activities in one or more assigned areas of billing, payment posting, collections, payor claims research, and other accounts receivable work. Works as a member of a… more
- SSM Health (Fond Du Lac, WI)
- …and payment rules. Bills claims appropriately. + Follows up on denied claims by performing appeals and denial recovery procedures. Works denied claim lines ... or more of the following: processing insurance payments, following up on denied claims , and resolving credit balances. May work in multiple functional areas. **Job… more
- Robert Half Accountemps (Los Angeles, CA)
- Description A Hospital in Los Angeles is in need of a Patient Account Representative . The Patient Account Representative will be responsible to manage patients' ... healthcare providers. - Perform billing and collection activities including insurance claims processing. - Respond to patient inquiries regarding billing, insurance… more
- CVS Health (Austin, TX)
- …excellent customer services for high volume in bound provider calls for the Claims Inquiry/ Claims Research team. Extensive claims research on multiple ... referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system . + Educates & assists… more
- PruittHealth (Norcross, GA)
- …timely payment. Responsible for contract analysis, reimbursement, denial management, appeals and resolving billing-related issues with insurance companies or other ... QA to insure accurate and timely creation of new claims and insures submitted claims meet payer...and deactivating old accounts as needed **Reporting** Reporting financial data , maintaining balance sheet schedules, and processing month end… more
- Robert Half Accountemps (Phoenix, AZ)
- …company systems to assist with customer needs, such as appointments, authorizations, claims , invoices, eligibility, benefits, and appeals + Accurately translate ... Description Remote Patient Service Representative Location: Remote Duration: 5 months, with a...health outcomes by connecting individuals with vital pharmacy benefits, data , and resources. Embrace a culture rooted in diversity… more
- Priority Health Care (Marrero, LA)
- …include following up on claim status, billing and re-billing of claims , credit balance resolution, denial management, following up on aging accounts, ... insurance companies, using contract summaries to verify balances due on disputed claims , and coordinating payor denial and appeal follow-up activities. This also… more
- MyFlorida (Tallahassee, FL)
- …(relocation benefits are not available for this position) OPS Employment Security Representative II This position will be used for multiple vacancies OPEN ... The Work You Will Do: This is an OPS Employment Security Representative II- Employment Review Specialist position in the Department of Commerce's Reemployment… more
- MyFlorida (Fort Lauderdale, FL)
- …(relocation benefits are not available for this position) OPS Employment Security Representative II This position will be used for multiple vacancies. OPEN ... issues and the chargeability of employer accounts for benefit payments on claims . This may be accomplished telephonically, through written correspondence, or through… more
- MyFlorida (Orlando, FL)
- …(relocation benefits are not available for this position) OPS Employment Security Representative II This position will be used for multiple vacancies OPEN ... The Work You Will Do: This is an OPS Employment Security Representative II- Employment Review Specialist position in the Department of Commerce's Reemployment… more
- State of Colorado (Colorado Springs, CO)
- …staff in the areas of employment matters; track, input, monitor and manage all data in the ERU tracking system. Position facilitates as a department liaison with the ... and maintains files for all grievances, State Personnel Board appeals , director's reviews, R6-10, and R5-6 meetings, as well...+ Track, gather and submit relevant information for unemployment claims ; + Position serves as a liaison between the… more
- Keystone Lab (Asheville, NC)
- … claims , when necessary, after payer contact. + Ensure that goals set for claims , denials, suspensions, and appeals on aged accounts are met within the set ... to resolve within payer timely filing parameters. Prepare, review, and transmit claims using billing software, including electronic and paper claim processing. +… more
- Jet Health (Fort Worth, TX)
- …members of the finance and operations teams to ensure that billing and claims data is reported regularly. Requirements Essential Duties and Responsibilities: + ... offs of reimbursement dollars. + Collect all necessary information to prepare claims and follow-through with corrections, resubmission, or appeals to resolve… more
- University of Rochester (Rochester, NY)
- Responsibilities **Job Summary:** The claims resolution representative II is responsible for working across the professional fee organization, performing ... include but are not limited to researching, correcting, resubmitting claims , submitting appeals and taking timely and...and taking timely and routine action to resolve unpaid claims . The ** Claims Resolution Representative … more
- University of Rochester (Rochester, NY)
- Responsibilities **General Purpose:** The Claims Resolution Representative III is responsible for working across the professional fee organization, handling ... process taking timely and routine action to resolve unpaid claims . The Claims Resolution Representative ...with appropriate departments to generate a detailed rational for appeals and grievances to the insurance companies. 10% Keeps… more
- CEENTA (Huntersville, NC)
- Primary Objective The Insurance Specialist creates and sends medical claims for the insurance companies and the patients. The Insurance Specialist is responsible for ... correct amount. Other responsibilities include following up on unpaid claims , clarifying discrepancies, reviewing bills, and confirming eligibility. Essential… more
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