- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Coordinator I Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los ... to support the safety net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Coordinator I supports the … more
- LA Care Health Plan (Los Angeles, CA)
- Manager, Customer Solution Center Appeals and Grievances Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los ... support the safety net required to achieve that purpose. Job Summary The Manager, Customer Solution Center Appeals and Grievances is responsible for the… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II (ALD) Job Category: Customer Service Department: CSC Appeals & Grievances Location: ... to support the safety net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Nurse Specialist LVN II Job Category: Clinical Department: CSC Appeals & Grievances Location: Los ... to support the safety net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Nurse Specialist LVN II is… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Quality Auditing Specialist II Job Category: Customer Service Department: CSC Appeals & ... support the safety net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Quality Auditing (QA) Specialist… more
- Trinity Health (Farmington Hills, MI)
- …Medical Group revenue operations ($3-5B NPR) of a Patient Business Services (PBS) center . Serves as part of a team of clinical payment resolution colleagues at ... Responsible for leveraging clinical knowledge and standard procedures to track appeals through first, second, and subsequent levels, and ensuring timely filing… more
- TEKsystems (Plano, TX)
- …Payment posting, Collection, Medical collections, Medical, Payment poster, Data entry, Customer service, Medical billing, Call center , medicaid, Collection ... Required: + 2+ years of Insurance follow-up, denials/ appeals experience (Medical A/R) + Hospital/facility collections experience...and other team leaders to confirm ie provide trending solutions * File complaints when appropriate for delays in… more
- Trinity Health (Farmington Hills, MI)
- …and/or Medical Group revenue operations ($3-5B NPR) of a Patient Business Services (PBS) center . Serves as part of a team of coding payment resolution colleagues at ... Responsible for leveraging coding knowledge and standard procedures to track appeals through first, second, and subsequent levels, and ensuring timely filing… more
- CVS Health (Harrisburg, PA)
- …care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just ... transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. Position… more
- CVS Health (Harrisburg, PA)
- …care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just ... transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. Position… more
- Beth Israel Lahey Health (Charlestown, MA)
- …PFS Hospital Billing Revenue Cycle may include Billing, AR Management, Customer Service, Cash Posting, Denial Management, and overall Revenue Cycle operations. ... manage resources and work unit costs within the constraints of the cost center budget. The Manager requires an advanced-level knowledge of hospital business office… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeal and...A minimum of 5 years experience in regulatory auditing ( Appeals & Grievances, Call Center , Enrollment) in a ... exemption requests prior to proceeding with the recruitment process. Job Summary The Customer Solution Center Audit Readiness Specialist II is responsible… more
- TEKsystems (Tempe, AZ)
- … service, call center Top Skills Details: customer service,call center Additional Skills & Qualifications: appeals experience is a plus but not ... business relationship of the assigned book of business. Ensures customer satisfaction and resolves client appeals in...partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of… more
- US Tech Solutions (Columbia, SC)
- …and related reprocessing actions. Reviews and adjudicates claims and/or non-medical appeals . Determines whether to return, deny or pay claims following ... guidelines. + *40% Examines and processes claims and/or non-medical appeals according to business/contract regulations, internal standards and examining guidelines.… more
- CVS Health (Fresno, CA)
- …and, may require coordination of responses from multiple business units. Ensure timely, customer focused response to appeals . Identify trends and emerging issues ... Anchored in our brand - with heart at its center - our purpose sends a personal message that...and report and recommend solutions . Independently coaches others on appeals ensuring… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- …healthcare providers with member benefits, eligibility, claims inquiry, claim reconsiderations and appeals . The Customer Service Representatives must be able to ... and communicate effectively with teams. + Transfer misdirected requests and offer solutions to non-routine issues. + Contribute to customer satisfaction and… more
- Brighton Health Plan Solutions, LLC (Melville, NY)
- … needs and concerns; demonstrate empathy and offer solutions . * Confirm customer understanding of the solution and provide additional customer education ... with member benefits, eligibility, claims inquiry, claim reconsiderations and appeals . This job description is not designed to cover...on ways to resolve problems to better serve the customer and/or improve productivity. * Offer solutions … more
- Albany Medical Center (Albany, NY)
- …securing revenue for services provided by physicians of Albany Med by competing appeals , phone calls, and account review. Qualifications: * High school diploma or ... GED is required. AAS degree is preferred. * Customer service experience required. * Experience providing phone-based customer service a plus. * Proficiency in… more
- Surgery Care Affiliates (Pinehurst, NC)
- …dynamic group of physician-driven, specialty care businesses that allows us to customize solutions , no matter the need or challenge: + We connect patients to ... part of Optum and with our new Specialty Management Solutions business. + We have pioneered a physician-led, multi-site...responses and resolution. The PAR will function within the Center 's policies and procedures, support SCA Values, SCA Vision… more
- LA Care Health Plan (Los Angeles, CA)
- …Management, Utilization Management, Risk Adjustment, Products, Customer Solution Center (CSC), reporting and Analytics, Appeals and Grievances and the ... when appropriate. Must demonstrate ability to work collaboratively and seek solutions proactively applying critical thinking skills in evaluating priorities and … more