- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II Job Category: Administrative, HR, Business Professionals Department: CSC Appeals & Grievances ... net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Nurse Specialist RN II Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, ... net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Nurse Specialist Registered Nurse (RN) II provides… more
- Carle (Urbana, IL)
- Outpatient Denial/ Appeals Specialist - RN + Department: Revenue Cycle - CFH_10_19 + Entity: Champaign-Urbana Service Area + Job Category: Clerical/Admin + ... Shift: Day + Location: Urbana, IL + Usual Schedule: Monday-Friday/ Hybrid + On Call Requirements: no + Work Location:...to establish and manage clinical and prior authorization denial appeals for the Carle enterprise. Represents Carle in clinical… more
- Area Agency On Aging 1-b (Southfield, MI)
- The Appeals and Compliance Specialist is responsible for providing comprehensive responses in compliance with contract, regulatory and accreditation requirements ... information and communicate disposition of case . + Triages case inquiries, appeals , and prepares case files/packets for appeal hearings. Attend State Fair Hearings… more
- LA Care Health Plan (Los Angeles, CA)
- …and/or exceed member satisfaction. Responsible for the day to day oversight of Appeals and Grievance Specialist by closely monitoring work, providing feedback on ... Lead Customer Solution Center Appeals and Grievances Job Category: Administrative, HR, Business...and or process improvement. Assist Supervisor to ensure that Specialist provide accurate, timely, and quality responses. Ensure that… more
- State of Colorado (CO)
- ECMC Enforcement Advisor (COMPLIANCE SPECIALIST IV) - Hybrid Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4633466) Apply ECMC ... Enforcement Advisor (COMPLIANCE SPECIALIST IV) - Hybrid Salary $70,140.00 - $91,200.00...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (Mesa County, CO)
- Highway Maintenance Specialist - Grand Junction MTC/Traffic Hybrid (CDL Required) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4660734) ... Apply Highway Maintenance Specialist - Grand Junction MTC/Traffic Hybrid (CDL...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- St. Luke's University Health Network (Allentown, PA)
- …of a patient's ability to pay for health care. The Accounts Receivable Specialist I is responsible for the billing and collection of the accounts receivable ... practitioner services for the St. Luke's Physician Group. The Accounts Receivable Specialist I is responsible for accurate and timely submission of claims to… more
- ClearChoiceMD (Concord, NH)
- …expedient care. ClearChoiceMD is seeking a dependable full-time accounts receivable specialist in Concord, NH. Successful candidates joining our TEAM will be ... employee's needs. A typical day in the life of an Accounts Receivable Specialist , includes: + Responsible for designated insurance claims to ensure submission of… more
- Methodist Health System (Dallas, TX)
- …**Your Job:** We are seeking an experienced Accounts Receivable II (AR II) Specialist specializing in Professional Billing for Family Practice to join our team in ... claims, denied claims, and correspondence. As an AR II Specialist , you will play a crucial role in optimizing...actions based on correspondence received, such as claim corrections, appeals , or adjustments. - Conduct thorough follow-up on aging… more
- CareFirst (Baltimore, MD)
- …the greater Baltimore/Washington metropolitan area who is willing and able to work in a hybrid model. The incumbent will be expected to work a portion of their week ... hospitalist, diabetes education, reduction of authorizations, reduction of claims appeals , etc.). Participate in internal and external committees and workgroups,… more
- Methodist Health System (Dallas, TX)
- …:** **Your Job:** The ability to manage the organization's third party payer appeals through the ability to analyze, research and successfully appeal third party ... claims within timely filing timelines, provide excellent customer service, write Appeal and Recon letters for follow-up in accordance with Departmental protocol with an emphasis on maximizing patient satisfaction and profitability. You will be responsible for… more
- State of Colorado (CO)
- CDOC - Human Resources Specialist IV (Employee Benefits Work Lead) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4663958) Apply CDOC - Human ... Resources Specialist IV (Employee Benefits Work Lead) Salary $5,845.00 -...after the initial training period. The FWA includes a hybrid workplace which is partly remote (work from home)… more
- Johns Hopkins University (Middle River, MD)
- …edits reports, file or pull EOB batches. + Identifies and escalates non-standard appeals to a higher-level specialist . + Informs the supervisor / Production ... responsible for the basic collection of unpaid third-party claims and standard appeals , using various JHM applications and JHU/ PBS billing applications. This role… more
- State of Colorado (CO)
- CDOC - Human Resources Specialist V (Human Resources Manager) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4652787) Apply CDOC - Human ... Resources Specialist V (Human Resources Manager) Salary $7,460.00 - $11,938.00...after the initial training period. The FWA includes a hybrid workplace which is partly remote (work from home)… more
- State of Colorado (CO)
- CDOC Marketing & Communications Specialist Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4654712) Apply CDOC Marketing & Communications ... Specialist Salary $4,809.00 - $7,695.00 Monthly Location Other (see...after the initial training period. The FWA includes a hybrid workplace which is partly remote (work from home)… more
- State of Colorado (Denver, CO)
- Youth Engagement Specialist Temporary Part Time Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4628762) Apply Youth Engagement Specialist ... state residents. Primary Physical Work Address Downtown/Denver Metro/Eligible for a hybrid (office/remote) work environment. FLSA Status Exempt; position is not… more
- Spectrum Billing Solutions (Skokie, IL)
- …We are looking to add a passionate and skilled Revenue Cycle AR Collections Specialist to our growing team. The ideal candidate will use their skills and knowledge ... includes all aspects of revenue cycle collections including denial management, appeals , reimbursement rate negotiation, and accounts receivable collections. This is… more
- State of Colorado (CO)
- CDOC - Human Resources Specialist IV (Employee Relations Work Lead) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4650990) Apply CDOC - ... Human Resources Specialist IV (Employee Relations Work Lead) Salary $5,845.00 -...after the initial training period. The FWA includes a hybrid workplace which is partly remote (work from home)… more
- State of Colorado (CO)
- Community Risk Reduction (CRR) Specialist Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4657657) Apply Community Risk Reduction (CRR) ... Specialist Salary $96,396.00 - $134,964.00 Annually Location Other (see...range. Positions with the Department of Public Safety are hybrid , requiring a minimum of two days in the… more