- Robert Half Accountemps (Eden Prairie, MN)
- Description Clinical Appeals Representative (Contract - Fully Remote) We're seeking a detail-oriented Clinical Appeals Representative to join our ... health insurance operations by managing documentation, coordinating with providers, and ensuring appeals and grievances are processed accurately and on time. This is… more
- Robert Half Office Team (Minneapolis, MN)
- …Are you looking for a rewarding remote role in healthcare administration? This Clinical Appeals Representative position offers the opportunity to make ... a meaningful impact while working from the comfort of your home. As a Clinical Appeals Representative , you will play a key role in managing the intake and… more
- Humana (Richmond, VA)
- …a team where your expertise truly makes an impact! As a Grievances & Appeals Representative , you'll be a go-to problem solver, turning complex challenges into ... clear resolutions. In this role, you'll dive deep into clinical documentation, analyze cases, and determine the best course...lives of those we serve. + Reviews level 1 appeals cases and ensures that information is accurate. +… more
- St. Luke's University Health Network (Allentown, PA)
- …regardless of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data ... coding determination made by the government or commercial payors, or their auditor representative . + Facilitate clinical chart reviews to assist with supporting… more
- Northwell Health (Melville, NY)
- …+ Ensures compliance with current state, federal, and third-party payer regulations. Ensures clinical reviews and appeals are up to date and accurately reflect ... medical necessity for assigned case. + Collaborates with physician advisor, payor representative and site case managers to facilitate appropriate level of care… more
- Ochsner Health (New Orleans, LA)
- …make a difference at Ochsner Health and discover your future today!** The Appeals Specialist is responsible for managing and resolving insurance claim denials and ... decisions. The position requires strong analytical skills and collaboration with clinical and revenue cycle teams to optimize financial outcomes. **Education**… more
- CVS Health (Woonsocket, RI)
- …to incoming correspondence and internal referrals. + Handles incoming requests for appeals and pre-authorizations not handled by Clinical Claim Management. ... Fluency in English and Spanish is required.** **Position Summary** Customer Service Representative is the face of Aetna and impacts members' service experience by… more
- Access Dubuque (Dubuque, IA)
- Customer Service Representative **Medical Associates** 1 Positions ID: ok7YyfwH Posted On 12/06/2025 **Job Overview** **Description** Medical Associates Business ... Office is hiring a **Customer Service Representative ** to answer patient questions via phone on a...issues. Handling EOB's, submitting physician notes for protests and appeals , resubmitting corrected HCFA's, protesting denials and follow-up to… more
- Reno Orthopedic Center (Reno, NV)
- Reno Orthopedic Center wants you to join the team as a Patient Billing Representative ! We are seeking an enthusiastic and dedicated team member to communicate with ... part of who we are; we strive for constant improvement in everything from clinical innovation to personal development. . We value kindnessas a core strength - it's… more
- Huron Consulting Group (Boston, MA)
- …Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new ... partnerships, clinical services and technology is not enough to create...employee engagement across the enterprise. + The Pre-Service Financial Representative supports the Revenue Cycle by financially clearing urgent… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Case Management Representative position is responsible for providing clerical assistance and data management support to the case management ... and routes issues to appropriate individuals, assists in resolution of non- clinical issues as needed + Facilitates and arranges acquisition of post-acute… more
- Guidehouse (Birmingham, AL)
- …+ Works 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 Representative (PAR) is expected to perform specific billing processes,… more
- Rochester Regional Health (Rochester, NY)
- Job Title: Business Office Representative Department: Location: Hours Per Week: Schedule: Sign-On Bonus: SUMMARY: Ensure full reimbursement is received by RRH for ... clinical services rendered including professional, long-term/home care and hospital...phone calls to the payer. Submit corrected claims and appeals . + Process account adjustments and refunds as needed… more
- Surgery Care Affiliates (Boise, ID)
- …do it. Each decision we make is rooted in seven core values: + Clinical quality + Integrity + Service excellence + Teamwork + Accountability + Continuous improvement ... change. If you join our team, they will. Responsibilities The Patient Account Representative will be responsible for thorough and timely patient account follow up… more
- Northwell Health (Glen Cove, NY)
- …billing/clerical staff regarding billing and office/clerical functions. + Carries out clinical documentation requests to business office to ensure timely appeals ... . + Implements policies and procedures to facilitate billing and maximize case collections. + Implements improvements for financial management of each billing area. + Performs related duties as required. All responsibilities noted here are considered essential… more
- Northwell Health (Melville, NY)
- …Guides billing/clerical staff regarding billing and office/clerical functions. + Coordinates clinical documentation requests to business office to ensure timely ... appeals . + Develops and implements policies and procedures to facilitate billing and maximize case collections. + Reviews and recommends improvements for financial… more
- University of Rochester (Rochester, NY)
- …closure and obtain maximum revenue collection. Researches, corrects, resubmits claims, submits appeals and takes timely and routine action to resolve unpaid claims. ... hospital departments or department representatives. + Researches and responds to clinical department inquiries on complex, high dollar, and specialized accounts and… more
- State of Colorado (Colorado Springs, CO)
- ADMINISTRATOR IV: Clinical Contracts Manager (Colorado Springs, Colorado) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5167059) Apply ... ADMINISTRATOR IV: Clinical Contracts Manager (Colorado Springs, Colorado) Salary $5,962.00 -...the official appeal form, signed by you or your representative . This form must be delivered to the State… more
- State of Colorado (Pueblo, CO)
- Social Work/Counselor III- Clinical Group Facilitator COT Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5039848) Apply Social Work/Counselor ... III- Clinical Group Facilitator COT Salary $82,620.00 - $115,668.00 Annually...the official appeal form, signed by you or your representative . This form must be delivered to the State… more
- State of Colorado (Denver, CO)
- Social Work III - Clinical Services Fort Logan Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5167030) Apply Social Work III - Clinical ... interventions and comprehensive aftercare plans with placement. Services include clinical assessment, treatment planning, individual therapy, group therapy, family… more