- Alight (IL)
- …meaning of Be Alight. Learn more at careers.alight.com. About the Role The Client Specialist manages claims , appeals , and ERISA deadlines. They also handle ... urgent client escalations and engage in quality assurance reviews. Additionally, they support teammates with workload management and interact with customer care or delivery teams. Responsibilities . Collaborating with the client manager and end client to… 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
- Martin's Point Health Care (Portland, ME)
- …Place to Work" since 2015. Position Summary Job Description Position Summary: The Appeals Specialist (Medicare or US Family Health Plan) is responsible for ... standards in accordance with CMS requirements + Cross-trains with US Family Health Plan Appeals Specialist to perform functions as needed US Family Health Plan… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II (ALD) Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los ... 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
- Universal Health Services (Richmond, VA)
- …The Atlantic Region CBO is seeking a dynamic and talented Senior Appeals Specialist . The Senior Appeals Specialist ... relating to technical issues identified during the billing of claims and the follow-up on the clinical appeals... claims and the follow-up on the clinical appeals performed by the facilities. Key Responsibilities include: +… more
- Universal Health Services (Richmond, VA)
- …Rico and the United Kingdom. The Atlantic Region CBO is seeking a dynamic and talented Appeals Specialist . The Appeals Specialist is responsible for the ... relating to technical issues identified during the billing of claims and the follow-up on the clinical appeals... claims and the follow-up on the clinical appeals performed by the facilities. Key Responsibilities include: +… more
- Trinity Health (Farmington Hills, MI)
- …as part of the payment resolution team that receives, analyzes, and appeals denials received for an assigned PBS location. Reviews, researches and resolves ... payment delays and/or variances resulting from rejected and/or denied claims and/or overpayments and underpayments with direction from the Supervisor Payment… more
- Trinity Health (Farmington Hills, MI)
- …Maintains knowledge of state/federal laws as they relate to contracts and the appeals process. Assists in training Payment Resolution Specialist I colleagues ... resolves payment delays and/or variances resulting from rejected and/or denied claims and/or overpayments and underpayments. Processes payments as appropriate in… 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
- Trinity Health (Farmington Hills, MI)
- …Responsible for leveraging coding 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 CPT-4 procedural codes for UB-04 outpatient or inpatient claims , or other coding reasons and processing charge corrections… more
- University of Virginia (Charlottesville, VA)
- …and obtain payment by coordinating resolution to rejected, denied, and outstanding claims to ensure timely collections. + Analyzes accounts that are not resolved ... within the time specified by the contract using their knowledge of coding and utilizing various tools of CPT and ICD-10 to determine causes of unresolved issues. Selects the most efficient and effective follow up strategy to resolve the accounts to obtain… more
- MetLife (Tampa, FL)
- …impact in the lives of our customers and our communities. The Lead LTD Claims Specialist manages a caseload of long term disability insurance claims ... time service standards. In this role, the Lead LTD Claims Specialist will be a technical expert...thorough manner. Identifies and refers appropriate matters to our appeals , complaint, or litigation support areas. * Serves as… 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 (Santa Ana, 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
- TEKsystems (Atlanta, GA)
- … specialists to support a growing healthcare company in the Waco area! As a claims follow up specialist on our team you will be verifying insurance information, ... you have experience working within medical insurance roles handling claims , payer portals, appeals , AR follow up,...increase cash flow Day to Day Duties: - Each specialist will be assigned an inventory to work. New… more
- HCA Healthcare (Asheville, NC)
- …where diversity and inclusion thrive? Submit your application for our Insurance and Claims Specialist (Program of All Inclusive Care for the Elderly) Program ... may vary by location._** We are seeking Insurance and Claims Specialist PACE Program, for our team...works with contracted, new, and potential network vendors regarding claims processing and payment concerns and appeals … more
- Robert Half Accountemps (Cincinnati, OH)
- …a healthcare client with an immediate need for a skilled full-time OR part-time Medical Claims Specialist . As a full-time OR part-time Medical Claims ... Benefits, Claim Denials, and Denial Codes * Handling of appeals in cases of denied claims * Ensuring adherence to medical billing/ claims /collections industry… more
- Robert Half Accountemps (Fort Wayne, IN)
- …are offering a contract to permanent employment opportunity for an Insurance Follow-Up Specialist in FORT WAYNE, Indiana. This role is in the healthcare industry and ... will involve follow-ups on medical claims . The workplace environment is business casual and requires...Manage Insurance Denials and Payer Denials, and handle Medical Appeals . * Leverage expertise in Insurance Follow-up, Claim Denials,… more
- Johns Hopkins University (Baltimore, MD)
- …Cycle Specialist III_** responsible for the collection of unpaid third-party claims and independent resolution of complex appeals , using various JHM ... Communicates with payers to resolve issues and facilitate prompt payment of claims . Communicates with providers regarding appeals and medical policy denials,… more
- State of Colorado (Denver, CO)
- Community Living Data & Claims Analyst Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4533291) Apply Community Living Data & Claims ... for overtime compensation. Department Contact Information Jessica Bosick, Talent Acquisition Specialist ~ ###@state.co.us How To Apply Please submit an online… more