- Covenant Health (Lubbock, TX)
- …+ Associate's Degree. + Three (3) years in managed care claims /reimbursement or other healthcare field. **Why Join Providence?** Our best-in-class benefits ... advancement. **Requsition ID:** 314837 **Company:** Covenant Jobs **Job Category:** Claims **Job Function:** Revenue Cycle **Job Schedule:** Per-Diem **Job Shift:**… more
- Elevance Health (Indianapolis, IN)
- **Title: Grievance/ Appeals Representative I** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 ... miles of one of our PulsePoint locations. The **Grievance/ Appeals Representative I** is responsible for reviewing,... I** is responsible for reviewing, analyzing and processing claims in accordance with policies and claims … more
- Humana (Columbus, OH)
- …of our caring community and help us put health first** The Grievances & Appeals Representative 4 manages client denials and concerns by conducting a ... skillsets and/or partnerships with clinical and other Humana parties. The Grievances & Appeals Representative 4 assumes ownership and leads advanced and highly… more
- Catholic Health Services (Melville, NY)
- …why Catholic Health was named Long Island's Top Workplace! Job Details The Appeals and Authorization Representative will perform activities to help facilitate ... limited to the following: Review providers' requests for services and coordinate appeals management review. Generate an appeal letter to substantiate the medical… more
- Commonwealth of Pennsylvania (PA)
- …+ Four years of experience in the determination of unemployment compensation claims , including adjustments, overpayments, and appeals supplemented by 6 college ... of full-time experience do you possess in the determination of unemployment compensation claims , including adjustments, overpayments, and appeals ? + 4 years or… more
- Texas Veterans Commission (Waco, 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 (Veteran Services Representative I)* **Location:**… more
- Robert Half Accountemps (Fort Wayne, IN)
- …This role is in the healthcare industry and will involve follow-ups on medical claims . The workplace environment is business casual and requires a high level of ... interaction with doctor offices. Responsibilities: * Follow-up on insurance claims and patient claims payments. * Provide customer service in relation to medical… more
- Banner Health (Mesa, AZ)
- …If you're looking to leverage your abilities - you belong at Banner Health. The Claims Follow Up PFS Representative CBO will be responsible for verification of ... eligibility and work edits on claims that are preventing claim from releasing, rejecting. Systems frequently used: MS4, Cerner, Finthrive claims and collections,… more
- Guidehouse (Lewisville, TX)
- **Job Family** **:** Patient Account Representative **Travel Required** **:** None **Clearance Required** **:** None **What You Will Do** **:** The Patient Account ... Representative (PAR) is expected to perform specific billing processes,...taking necessary actions to obtain account resolution + Submits appeals , as appropriate, for all non-clinical denials + Monitors… more
- Guidehouse (Lewisville, TX)
- **Job Family** **:** Patient Account Representative **Travel Required** **:** None **Clearance Required** **:** None **What You Will Do** **:** The **Insurance ... Patient Account Representative ** is an extension of a client's business office...at ###_** **Essential Job Functions** + Account Review + Appeals & Denials + Medicare/Medicaid + Insurance Follow-up +… more
- State of Indiana (Fort Wayne, IN)
- …for protested claims . + Determine exhibits to be offered during appeals hears and defend determinations. + Receive, investigate, and correct system error list ... Claims Investigator Date Posted: Sep 10, 2024 Requisition...accessible, and equitable workplace with a workforce that is representative of Indiana's population. As a proud equal opportunity… more
- Catholic Health Services (Melville, NY)
- …Details Under the direction of the Hospital RRC Manager, the RRC Follow-Up Representative is responsible to review all assigned third-party and/ or patient accounts, ... actions as initiating phone calls and website inquiries, drafting and submitting letters/ appeals , attending payer meetings in order to move accounts forward in the… more
- CDPHP (Albany, NY)
- …+ Demonstrated ability to determine, analyze and solve problems related to benefits, claims appeals , claims pricing/processing by utilizing all applicable ... be a part of that experience. The Provider Services Representative shall assume full responsibility and ownership for all... will address and resolve service related issues including appeals and complaints, eligibility determination and claims … more
- Houston Methodist (Houston, TX)
- …functions, including claims resubmission to payors. + Creates and submits appeals when necessary. Engages the coding follow-up team for any medical necessity or ... At Houston Methodist, the Account Representative position is responsible for resolving all outstanding third party primary and secondary insurance claims for… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- …revenue agencies and other healthcare providers with member benefits, eligibility, claims inquiry, claim reconsiderations and appeals . The Customer Service ... + Handle inbound calls from members, medical providers, and others. + Adjust claims accurately, if needed. + Listen to and address customer needs and concerns… more
- CVS Health (Orlando, FL)
- …in a pharmacy operation setting at our Patient Financial Service Centers, supporting the claims follow up, denial, and appeals processes. The candidate will work ... out of an unbilled queue and aged worklist queue processing denials, unpaid claims , primary and secondary billing efforts for both commercial and government payers.… more
- Sanford Health (Fargo, ND)
- …lunch break. This is an in-office position. **Job Summary** The Insurance Representative processes and monitors unpaid third party insurance, Medicare, Medicaid or ... to work accounts throughout the entire revenue cycle. Prepares and submits claims to payers either electronically or by paper. Secures necessary medical… more
- Catholic Health Services (Melville, NY)
- …the direction of the Physician Revenue Realization Manager, the Insurance Follow-Up Representative is responsible for investigating claims status with insurance ... the direction of the Physician Revenue Realization Manager, the Insurance Follow-Up Representative is responsible for investigating claims status with insurance… more
- UNC Health Care (Chapel Hill, NC)
- …philosophy. Job Responsibilities: + Responsible for the accurate and timely submission of claims follow up, reconsideration and appeals , response to denials, and ... a variety of complex duties, including but not limited to, working outstanding insurance claims follow up for no response from payors, and/or claim denials. + Works… more
- Veterans Benefits Administration (New Orleans, LA)
- …C&P laws and regulations, or include precedent opinions of the Court of Appeals for Veterans' Claims and authoritative opinions of the General Counsel. ... Summary The Supervisory Veterans Service Representative (Coach) leads an assigned team within the...advice, and assistance on all types of Veterans Benefits Claims Administered to veterans and their dependents and for… more