- Northwell Health (Melville, NY)
- …as needed. + Prior experience in Case Management, Utilization Review, and Appeals / Denials , highly preferred. *Additional Salary Detail The salary range and/or ... and the third party payer. Prepares and defends level of care and medical necessity for assigned case. Collaborates with physician advisor, payor representative … more
- Guidehouse (Birmingham, AL)
- …HS Diploma or equivalent. + 0-2 years medical provider experience working with UB04, appeals & denials . **What Would Be Nice to Have** **:** + Basic computer ... None **Clearance Required** **:** None **What You Will Do** **:** The Central Denials Account Representative conducts thorough account reviews to determine the… more
- Guidehouse (Birmingham, AL)
- …**:** None **Clearance Required** **:** None **What You Will Do** **:** The Denials Patient Account Representative will manage, update and prepare a variety ... as needed with various projects and review and resolve denials . They will submit facility and non-clinical appeals...3 years related or general knowledge of payor-specific or medical specialty billing **What Would Be Nice To Have**… more
- Humana (Frankfort, KY)
- …a part of our caring community and help us put health first** The Grievances & Appeals Representative 3 manages client denials and concerns by conducting a ... with clinical and other Humana parties. The Grievances & Appeals Representative 3 performs advanced administrative/operational/customer support duties… more
- Community Health Systems (Franklin, TN)
- …Duties and Responsibilities:** include the following. Other duties may be assigned. + File medical necessity and level of care appeals using InterQual and CMS ... to appropriate persons. + Maintain documentation regarding all payor resources regarding denials and appeals processes. + Understand and apply CHS 10-Step… more
- St. Luke's University Health Network (Allentown, PA)
- …regardless of a patient's ability to pay for health care. The Coding Appeals Specialist retrospectively reviews patient medical records, claims data and coding ... AMA CPT, are assigned to support the services/treatment rendered. The Coding Appeals Specialist also prepares appeal arguments and/or letters to support and defend… more
- Houston Methodist (Houston, TX)
- … appeals when necessary. Engages the coding follow-up team for any medical necessity or coding related appeals . **GROWTH/INNOVATION ESSENTIAL FUNCTIONS** + ... At Houston Methodist, the Account Representative position is responsible for resolving all outstanding...This position performs collections activities on simple and complex denials and on outstanding insurance balances in the professional… more
- Surgery Care Affiliates (Boise, ID)
- …a patient account representative . + Candidate MUST HAVE knowledge of medical billing, payer follow-up, payer contracts, appeals , self-pay billing, Medicare ... Training, and Experience: + High school graduate. Previous Clinical, Accounts Receivable, Medical Billing appeals and patient billing and collection experience… more
- UT Health (Houston, TX)
- …to prevent future denials and further delay in payments. 4. Pursues appeals and takes the necessary steps to bring accounts to resolution. 5. Analyzes accounts ... Patient Account Representative II - Revenue Cycle **Location:** Houston, Texas...Revenue Cycle **Location:** Houston, Texas **Hot** **Category:** Professional/Managerial McGovern Medical School at UTHealth Houston Requisition #: 240003DC **What… more
- Guidehouse (Birmingham, AL)
- …all denials taking necessary actions to obtain account resolution. + Submits appeals , as appropriate, for all non-clinical denials + Monitors all denials ... **Job Family** **:** Patient Account Representative **Travel Required** **:** None **Clearance Required** **:** None **What You Will Do** **:** The Patient Account … more
- Guidehouse (Lewisville, TX)
- …all denials taking necessary actions to obtain account resolution + Submits appeals , as appropriate, for all non-clinical denials + Monitors all denials ... **Job Family** **:** Patient Account Representative **Travel Required** **:** None **Clearance Required** **:**...creating a diverse and supportive workplace. Benefits include: + Medical , Rx, Dental & Vision Insurance + Personal and… more
- WellSpan Health (York, PA)
- …trend analysis to management, leadership, and insurance liaison.- Writes and submits appeals when needed to overturn claim denials .- Accesses external payer ... Patient Financial Services Representative II - Govt Billing - Days Location:...researches claim denial for resolution and submits disputes and appeals . Represents the System in a professional manner while… more
- Guidehouse (El Segundo, CA)
- …Be Nice To Have** **:** + 1+ year's medical provider experience working with UB04, appeals & denials . + Hospital or EOB claims emphasis + PC skills in a ... **Job Family** **:** Patient Account Representative **Travel Required** **:** None **Clearance Required** **:**...Job Functions** + Hospital Claims + Account Review + Appeals & Denials + Medicare/Medicaid + Insurance… more
- Houston Methodist (The Woodlands, TX)
- …on insurance/managed care benefits + Supports and assists with concurrent insurance denials and appeals process, transmission of utilization reviews to insurance ... At Houston Methodist, the Case Management Representative position is responsible for providing clerical assistance and data management support to the case management… more
- UNC Health Care (Smithfield, NC)
- …procedures and practices necessary to collect carrier accounts receivable and resolve denials . Participates and assists in special projects. Assists new or existing ... reflects UNC Health Care's mission and philosophy. Responsibilities: 1. Appeals & Managed Care Escalations: Project Manage all 3rd...claim is valid and if not, abstracts information from medical records to support appeal of denial. Works in… more
- Whidbey General Hospital (Coupeville, WA)
- JOB SUMMARY The Patient Financial Services Representative supports the mission of providing quality healthcare to the patients of WhidbeyHealth by performing a ... support the financial health and well-being of the organization. The PFS Representative may be responsible for coordinating patient referrals and subsequent follow… more
- Indian Health Service (Wellpinit, WA)
- …accurate patient information, clinical data, obligation signatures and fiscal data. In appeals or denials , employee gathers all necessary information pertinent ... eligible for coverage by third party resources for patient care and to ensure the medical care provided by third party resources is paid. This job announcement is to… more
- Garnet Health (Middletown, NY)
- …a must, with knowledge in Revenue/CPT Code descriptions and the ability to write appeals for denials is required. Should know the statutes and CMS regulations ... we invite to make your career home with us as a Patient Accounting Representative on our Patient Financial Services team at/in Garnet Health Medical … more
- Guidehouse (San Antonio, TX)
- …For insurance specific clients: 1+ year medical provider experience working with UB04, appeals & denials . + PC skills in a Windows environment are required ... **Job Family** **:** Patient Account Representative **Travel Required** **:** None **Clearance Required** **:**...creating a diverse and supportive workplace. Benefits include: + Medical , Rx, Dental & Vision Insurance + Personal and… more
- Corewell Health (Grand Rapids, MI)
- …verifies that prior authorization has been obtained; assists with retroactive insurance denials / appeals . + Responsible for complex EMR/EHR scanning and Right Fax ... higher depending on years of experience. Job Summary As a Patient Services Representative with Corewell Health, you'll play a vital role in delivering top-notch… more