- Accounting Now (Tampa, FL)
- …Specialists to compile appropriate documentation and medical records to submit appeals or corrected claims in a timely mannerThis position applies prior ... via payer portal, fax, etc Documents and summarizes all rationale for all appeals in EPICDocuments communications with medical office staff and/or MD provider… more
- US Tech Solutions, Inc. (Columbia, SC)
- …research as needed to resolve inquiries. . Reviews and adjudicates complex or specialty claims and/or non- medical appeals . . Determines whether to return, ... of response or extensive research. . Examines and processes claims and/or non- medical appeals according to business/contract regulations, internal standards… more
- Blanchard Valley Health System (Findlay, OH)
- …and writes appeals for denials associated with the payment of claims within the department/division. Maintains appropriate timeliness of appeals for denials. ... PURPOSE OF THIS POSITION The Denial Management Specialist is responsible for the timely review and...A/R and payer issues, avoid timely claim consideration/filing, failed appeals , and/or increased denials & write-offs. Participates in and… more
- Dialysis Clinic, Inc. (Sacramento, CA)
- …all primary payments and denials for accuracy as well as sending out initial claims , corrected claims and appeals .Starting pay: $23.00/hr. This position is ... with a lower caregiver-to-patient ratio than other providers.The AR Specialist will provide continual and accurate documentation regarding eligibility,… more
- Spectraforce Technologies Inc (Atlanta, GA)
- …and attention to detail. General knowledge of accounting principles, pharmacy operations, and medical claims . Acceptable use of medical industry vernacular. ... Title: Patient Access Specialist Location: Remote Duration: 3+ month's Shift timings:...could include but not limited: Billing and coding support. Claims assistance, tracking and submission. Prior authorization assistance and… more
- Northeast Georgia Health System, Inc (Oakwood, GA)
- …of Protected Health InformationAbility to manage changeExtensive knowledge of medical terminology Must possess detailed understanding and knowledge of insurance ... and interprets clinical information submitted from the Physician, emphasizing the medical justification for a procedure, in order for completion of the… more
- Accounting Now (Pinellas Park, FL)
- … Billing and Collections Specialists in St Petersburg, Florida. Billing & Collections Specialist The medical billing and collection specialist is responsible ... Medicaid, Medicaid Managed Care, and commercial insurance payers. The medical billing and collection specialist must possess...claims if needed and or ability to process appeals online or via paper submission; Assist with billing… more
- TEKsystems (Addison, TX)
- …the appeals and arbitration process for denied or underpaid claims , ensuring timely and accurate submissions. - Prepare compelling appeal letters, supporting ... Description: - Review and analyze denied claims , payment discrepancies, and reimbursement issues to identify...necessity, and reimbursement methodologies to strengthen appeal arguments. Skills: Appeals , Claim, medical collections, Medical … more
- Martin's Point Health Care (Portland, ME)
- …adherence to Standard Operating Procedures (SOP) to determine next steps + Evaluates medical claims and coverage policy documentation to determine validity of ... and external customers + Cross-trains to perform either Medicare or USFHP Appeals Specialist functions as needed Education/Experience: + Bachelor's Degree or… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II Job Category: Customer Service 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) Specialist II will receive, investigate and resolve… more
- Carle (Urbana, IL)
- Outpatient Denial/ Appeals Specialist - RN + Department: Revenue Cycle - CFH_10_19 + Entity: Champaign-Urbana Service Area + Job Category: Clerical/Admin + ... appeals for the Carle enterprise. Represents Carle in clinical meetings and writing appeals on outpatient accounts where medical necessity, level of care or… more
- Molina Healthcare (Georgetown, KY)
- …the likelihood of a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge, ... Experience in the specific programs supported by the plan such as Utilization Review, Medical Claims Review, Long Term Service and Support, or other specific… more
- The Mount Sinai Health System (New York, NY)
- …The DRG Appeals Analyst - CDI Liaison is responsible for analyzing medical records, claims data, and coding on all diagnoses and procedures (both ... medical and surgical) to assure properly assigned diagnostic related...codes, DRG and CPT coding. **REQUIRED SKILLS** Certified Coding Specialist **ABOUT US** **Strength Through Diversity** The Mount Sinai… more
- Billings Clinic (Billings, MT)
- …starting. Click here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) to learn more! Claims Specialist I - CBO ... claims from government and third-party payers. The Claims Specialist is responsible for preparing and...of refunds, if appropriate, and coordinating adjustments, when necessary, claims appeals or resubmissions, moving balances from… more
- Illumination Foundation (Riverside, CA)
- …across Orange County, Los Angeles County and the Inland Empire. Job Description The Claims Specialist is responsible for accuracy of claims submission, ... benefits and eligibility verification, accuracy of client information. In addition, the Claims Specialist is also responsible for keeping up to date accounts… more
- Whitney Young Health Center (Watervliet, NY)
- …Apply Description GENERAL RESPONSIBILITIES: Responsible for reviewing medical claims prior to submission and ... Claims Coding Specialist (Req 100825) Watervliet, NY... in accordance with contracts, calling payers on open claims , sending appeals on denied claims … more
- Axis (Princeton, NJ)
- …upon request for candidates taking part in the selection process. AXIS is seeking a Claims Specialist to join our North America Accident & Health Claims ... accident and health insurance claim management experience required, including experience with medical claims and cost containment. + Prior experience auditing… more
- MetLife (Bloomfield, CT)
- …lives of our customers and our communities. The Senior Long Term Disability (LTD) Claims Specialist evaluates long term disability insurance claims in ... time service standards. In this role, the Senior LTD Claims Specialist is required to exercise independent...thorough manner. Identifies and refers appropriate matters to our appeals , complaint or litigation support areas * Compiles file… more
- MetLife (Cary, NC)
- …* Independently manage an assigned caseload of the most complex claims which consists of pending, ongoing/active and appeal reviews. Provides timely, ... balanced and accurate claims reviews, documentation and recommended decisions in a time...and CPAs, as needed, to gather data such as medical /occupational information in order to ensure reasonable, thorough decisions.… more
- Robert Half Accountemps (Fort Wayne, IN)
- …Indiana. 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 ... billing and insurance follow-ups. * Utilize skills in Medical Claims , Medical Billing, and...* Manage Insurance Denials and Payer Denials, and handle Medical Appeals . * Leverage expertise in Insurance… more
