- Medical Mutual of Ohio (Brooklyn, OH)
- …will consider collective experience, training and education. . 5 years as an Appeals Specialist or equivalent experience in Medicare health insurance claims, ... appeal/grievance requests and electronic inquiries in order to identify and classify appeals and grievances as outlined in policies and procedures. Using internal… more
- TEKsystems (Addison, TX)
- …to strengthen appeal arguments. Additional Skills & Qualifications: - Proven experience as an Appeals and or denials Specialist or in a similar role within a ... reimbursement issues to identify the root causes. - Initiate and manage the appeals and arbitration process for denied or underpaid claims, ensuring timely and… more
- Commonwealth Care Alliance (Boston, MA)
- …clinical, operations, pharmacy, dental, reporting, and member services. * Supports the Senior Appeals & Grievance Coordinator and A/G Coordinator in day-to-day ... CCA- Appeals & Grievances Processing of Grievances & Appeals : * Responsible for the progress of grievance and appeal intervention and resolution. * Assure verbal… more
- Johns Hopkins University (Middle River, MD)
- … and rejections processes to resolve standard issues or escalate to a more senior specialist . **Specific Duties & Responsibilities** + Uses A/R follow-up systems ... file or pull EOB batches. + Identifies and escalates non-standard appeals to a higher-level specialist . + Informs the supervisor / Production Unit Manager of… more
- Rochester Institute of Technology (Rochester, NY)
- …Department of Biomedical Engineering at RIT is seeking applicants for Senior Staff Specialist - Grad Studies. The Sr . Staff Specialist for Graduate ... **9279BR** **Position Title:** Sr Staff Specialist - Graduate Studies...or graduate program director with student waiver of suspension appeals + Prepare student full time equivalency forms to… more
- University of Utah (Salt Lake City, UT)
- Details **Open Date** 10/25/2024 **Requisition Number** PRN40195B **Job Title** PS Sr Laboratory Specialist **Working Title** PS Sr Laboratory Specialist ... medicinal chemistry and vascular surgery. We seek a lab specialist to manage lab logistics, perform seminal scientific experiments,...assist in managing laboratory setup, and inventory. If this appeals to you, please apply by sending your CV… more
- HCA Healthcare (Nashville, TN)
- …care like family! Jump-start your career as a Coding Operations Education and Appeals Consultant today with HCA Healthcare. The Coding Operations Education and ... Appeals Consultant is responsible for assisting in the efficient...(tuition, student loan, certification support, dependent scholarships) + Colleague recognition program + Time Away From Work Program (paid… more
- CACI International (Washington, DC)
- Sr Congressional and Public Affairs Specialist /Advisor Job Category: Consulting Time Type: Full time Minimum Clearance Required to Start: TS/SCI Employee Type: ... PREM). More About the Role: As a Congressional and Public Affairs Specialist /Advisor you will: + Collect, review, assess, and demonstrate congressional information,… more
- MetLife (Tampa, FL)
- …and thorough manner. Identifies and refers appropriate matters to our appeals , complaint or litigation support areas Essential Business Experience and Technical ... Skills: Required: *Prior experience with independent judgement and decision making while relying on the available facts *Be able to demonstrate the use of critical thinking and analysis when reviewing the information *Creative problem-solving abilities and the… more
- Exelon (Baltimore, MD)
- …and Representatives for the daily performance of work. Investigates customer appeals and supports resolutions. Analyzes end to end processes, recommends/champions ... changes and conducts internal and external training as needed. Serves as team lead and acts as a liaison in facilitating high volume workload initiatives, such as daily transaction processing and the management of system exceptions. Fosters the spirit of… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Sr Coding Specialist position is responsible for applying correct coding conventions to patient charge encounters in a clinical ... errors in the electronic health record. In addition, the Sr Coding Specialist position is responsible for...posting to the assigned work queues. + Investigates and appeals unpaid, denied and partially paid claims by third… more
- Clark County, NV (Las Vegas, NV)
- SENIOR ECONOMIC DEVELOPMENT SPECIALIST Print (https://www.governmentjobs.com/careers/clarkcounty/jobs/newprint/4705378) Apply SENIOR ECONOMIC DEVELOPMENT ... Development is seeking qualified candidates to apply for the Senior Economic Development Specialist position. This individual...printed materials and a computer screen; and hearing and speech to communicate in person or over the telephone.… more
- Clark County, NV (Las Vegas, NV)
- SENIOR FINANCIAL OFFICE SPECIALIST Print (https://www.governmentjobs.com/careers/clarkcounty/jobs/newprint/4722644) Apply SENIOR FINANCIAL OFFICE ... Finance is seeking qualified candidates to apply for the Senior Financial Office Specialist position. As a...printed materials and a computer screen, and hearing and speech to communicate in person or over the telephone.… more
- Sacramento County (Sacramento, CA)
- Senior Behavioral Health Peer Specialist Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/2979607) Apply Senior Behavioral Health ... Street, Room 2640, Sacramento, CA 95814, telephone: ###. Such appeals must be filed within thirty (30) calendar days...best describes how you meet the minimum qualification for Senior Behavioral Health Peer Specialist . Current or… more
- MetLife (Bloomfield, CT)
- …a meaningful impact in the lives of our customers and our communities. The Senior Long Term Disability (LTD) Claims Specialist evaluates long term disability ... within prescribed time service standards. In this role, the Senior LTD Claims Specialist is required to...thorough manner. Identifies and refers appropriate matters to our appeals , complaint or litigation support areas * Compiles file… more
- Chesapeake Regional Healthcare (Chesapeake, VA)
- The Senior Coding Specialist is responsible for performing coding tasks required to promote efficient operation of the physician practices within Chesapeake ... + Report all payments on collection claims to the Collections Specialist (s) + Attend required hospital-wide orientations, meetings, and in-services + Demonstrate… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** Senior Contract Specialist works closely with Corporate Governance (Legal), Government Affairs, Product, Marketing, ... Insurance Administration surveys as needed and assigned. Responds to Central Appeals Unit, Executive Inquiry, Corporate + Audit and other department inquiries… more
- Amazon (Arlington, VA)
- …sellers around the world. Amazon is seeking an experienced Health & Welfare Operations Senior Specialist to join our Benefits Operations Services Team. This role ... savings related topics. Work with internal employee support teams to manage appeals and exceptions intake, review and determination. (5% of role) Basic… more
- LogixHealth (Bedford, MA)
- …Review A/R reports to follow up on any unpaid claims + Submit required appeals when needed + Submit any required documentation to insurance companies as requested + ... One to two years related billing experience preferred; Previous Billing Specialist experience highly desired. Prior word processing, spreadsheet and internet… more
- City and County of San Francisco (San Francisco, CA)
- …of all races, ethnicity, sexual orientation, and gender identity to apply. 9775 Senior Community Development Specialist II - Program Manager The Homeownership ... and program enhancements. Important Information: Classification - 9775 - Senior Community Development Specialist II - (Program...to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or… more