- Martin's Point Health Care (Portland, ME)
- …Plan benefits, particularly as it relates to Member Appeals + Cross-trains with Medicare Appeals Specialist to perform functions as needed Overall Key ... Place to Work" since 2015. Position Summary Job Description Position Summary: The Appeals Specialist ( Medicare or US Family Health Plan) is responsible for… more
- Kelsey-Seybold Clinic (Pearland, TX)
- …to the Grievance and Appeals Department for Medicare Advantage appeals . The Utilization Review Specialist (LVN) is responsible for completion and review ... **Responsibilities** The Utilization Review Specialist (LVN) is responsible for conducting medical reviews,...Texas Department of Insurance (TDI) and or Centers for Medicare and Medicaid (CMS) and healthplan requirements. The Utilization… 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
- Trinity Health (Farmington Hills, MI)
- …Position (Pay Range: $39.8218-$59.7327) Applies clinical and comprehensive payer and appeals knowledge in reviewing all post-billed denials (inclusive of clinical ... of claim escalations. Responsible for leveraging clinical and broad payer and appeals knowledge, and standard procedures to track appeals through first,… more
- Trinity Health (Farmington Hills, MI)
- …Responsible for leveraging clinical knowledge and standard procedures to track appeals through first, second, and subsequent levels, and ensuring timely filing ... of appeals as required by payers, in addition to promoting...and reviews findings with all levels of Payment Resolution Specialist for further review. Serve as a resource to… more
- MCG Health System (Augusta, GA)
- Denials and Appeals Specialist Work Location: Satellite Location Req Number: 35021 Department Name: Prof Rev Cycle Svcs Shift: Days/No Weekends Position Status: ... Results or Job Cart. Position Description The Denials and Appeals Specialist is responsible for timely and...experience in Hospital or Professional Billing Experience. Proficient in Medicare Part A and B, Medicaid billing with an… more
- Abbott (Plano, TX)
- …Our 114,000 colleagues serve people in more than 160 countries. **Sr. Appeals Specialist , Patient Therapy Access Team** **Position Location: 6600 Pinecrest ... Our location in **Plano, TX** currently has an opportunity for a **Sr. Appeals Specialist ** . This role is responsible for facilitating and assisting… more
- Universal Health Services (Bonham, TX)
- …day. TMC Bonham is managed by Texoma Medical Center, subsidiary of UHS. The Appeals Specialist is responsible for appealing all insurance denials and prepare ... payers in compliance with Managed Care contracts and government fee schedules. The Appeals Specialist will obtain, manipulate, and analyze data from a variety… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Training Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los ... achieve that purpose. Job Summary The Customer Solutions Center Appeals and Grievances (A&G) Training Specialist II...A minimum of 3-5 years of Managed Care, Medicaid, Medicare experience required. A minimum of 3-5 experience in… more
- Alameda Health System (San Leandro, CA)
- Care Management Clinical Appeals Specialist + San Leandro, CA + Finance + Patient Financial Svcs - Facil + Full Time - Day + Business Professional & IT + Req ... Coordinates and executes the appeal process for all AHS facilities clinical appeals and third party audits. **DUTIES & ESSENTIAL JOB FUNCTIONS:** NOTE: The… more
- Elderwood (Buffalo, NY)
- …Medical Billing Specialist to join our team. Medical Billing Specialist ( Medicare /Managed Care) Position Overview: + Elderwood Administrative Services is ... Life Insurance, Medical, Dental, and Vision insurance Responsibilities Medical Billing Specialist ( Medicare /Managed Care): + Review remittances for potential… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Revenue Cycle Specialist is responsible for providing direct and indirect revenue cycle support to the Revenue Cycle Managers. It is ... identified by the Revenue Cycle Managers. In addition, the Revenue Cycle Specialist is responsible for resolving all outstanding third-party primary and secondary… more
- Robert Half Accountemps (New Orleans, LA)
- Description Robert Half has partnered with a client seeking a Medical Biller/Collections Specialist in the non-profit industry. The role we are seeking is that of a ... Medical Biller/Collections Specialist , who will be an integral part of our...Medisoft to track and process billing information * Handle appeals in cases of disputed charges, working to resolve… more
- Tarrytown Rehabilitation & Nursing Center (Everett, MA)
- …knowledge (Medicaid, Medicare ) and case management process (prior authorization and appeals ) required + Ability to multi-task and adapt to changing priorities + ... CLINICAL REIMBURSEMENT SPECIALIST / MULTI FACILITY We offer competitive compensation and...Ensures compliance with federal and state regulations, MA Medicaid, Medicare and Managed Care payment systems. Monitors, consults, and… more
- The Wesley Community (Saratoga Springs, NY)
- Medical Billing Specialist Full Time | Day Shift | 8am-4:30pm ** Pay rate $ 20-23 /hour ** The Wesley Community is no longer requiring employees to be vaccinated for ... heart. What will I do as a Medical Billing Specialist for The Wesley Community? + Process mail and...+ Prepare and produce all Wesley primary billing for Medicare , HMO, VA, MLTC as well as secondary Medicaid… more
- BrightSpring Health Services (Louisville, KY)
- Our Company BrightSpring Health Services Overview The Clinical Coding and Audit Specialist monitors, responds and performs the clinical coding and audit support ... processing of all episodes of care. Reviews documentation for appeals processes across the Home Health enterprise for all...Acts as a resource and has expert knowledge of Medicare , Medicaid, ICD-10 Coding and OASIS and other applicable… more
- Conduent (Los Angeles, CA)
- …where individuality is noticed and valued every day. **Insurance/Collections Specialist ** **Pay $18-20hr based on experience** The Insurance/Collections ... not limited to analyzing the overpayment data, and handling disputes and appeals from providers, and navigating difficult collection situations to resolution. Must… more
- Houston Methodist (Katy, TX)
- …of hospital billing and insurance follow up experience is required** Medicare experience is preferred** Epic experience is preferred** Hybrid position-location: 701 ... S Fry Rd 77450 (Katy)** At Houston Methodist, the Accounts Receivable Specialist position is responsible for billing and follow up of insurance or institutional… more
- Sharp HealthCare (San Diego, CA)
- …information necessary for activities related to Medical Groups' Quality and Appeals processes. + Demonstrates knowledge of department policies and procedures ... regulatory and health plan guidelines for issuance of notice letters ie Medicare notice of non-coverage, Commercial notice of non-coverage or Exhaustion of Benefit… more
- The New Jewish Home (Bronx, NY)
- …Finance Department in Waters Place, Bronx is seeking a full time Managed Care Billing Specialist to join our team. The Managed Care Specialist is responsible for ... create project spreadsheets for submission to payers, write reconsideration appeals and send to MCOs, and be able to...skilled nursing home billing is required + Must Understand Medicare , Managed Care, Medicaid (NY) billing and reimbursement +… more