- Optum (San Juan, PR)
- …in reviewing, researching, investigating, negotiating and resolving all types of appeals and grievances. This position will communicate with appropriate parties ... regarding appeals and grievance issues, implications and decisions. In addition,...decisions. In addition, analyze and identifies trends for all appeals and grievances. Primary Responsibilities: Manage and resolve healthcare… more
- US Tech Solutions (Myrtle Beach, SC)
- …Work Experience: 2 years of customer service experience including 1-year claims or appeals processing OR Bachelor's Degree in lieu of work experience. C2 clearance ... as needed to resolve inquiries. Reviews and adjudicates claims and/or non-medical appeals . Determines whether to return, deny or pay claims following organizational… more
- High Desert Medical Group (Lancaster, CA)
- High Desert Medical Group is seeking a full time Member Services Representative . This individual will be responsible for a variety of tasks that lead to a high level ... of customer satisfaction. Member Service Representative is responsible for receiving incoming calls, for greeting...and accepting any forms. Advise members of referral, denial, appeals and grievance processes. Serve as a liaison for… more
- Sonder Health Plans, Inc. (Atlanta, GA)
- …PCP lookup, appointment setting, scheduling transportation, and documenting Grievance and/or appeals ). Follow up on resolution of inquiries and communicating to all ... parties involved, in a timely and professional manner. Attends Customer Service & staff training, as required. Assists and supports other Member Services Department staff, as needed. Maintains and keeps in total confidentiality, all files, documents, and… more
- CAPPS (Midland, TX)
- …state law in the adjudication process. *Prepares and files claims and appeals with supporting evidence for successful adjudication. *Advises and assists veterans and ... any reasonable accommodation for the interview process, please inform the hiring representative who calls to schedule your interview. This position has been… more
- University Medical Center of Southern Nevada (Las Vegas, NV)
- …in scanning and understand the process of follow-up, and denials and appeals Knowledge, Skills, Abilities, and Physical Requirements Knowledge of: Office theories ... in scanning and understand the process of follow-up, and denials and appeals 05 Please detail your experience with Physician Billing and Account Follow-up.… more
- The Christ Hospital (Cincinnati, OH)
- …for the research and resolution of all unpaid claims and the preparation of appeals for rejected or denied claims. Responsible for the timely and accurate manual and ... electronic posting of patient and insurance provider payments, processing regular auditing and reconciliation reports. Review patient encounter reports to ensure accuracy and enter medical charges to initiate claim submission to ensure regulatory and… more
- Heluna Health (Los Angeles, CA)
- …and signed forms needed for disability, age-based, and retirement applications and appeals for SSI, SSDI, and CAPI. Safely and securely manage sensitive personal ... applications that result in benefits awards. Act as the Authorized Representative for clients applying for SSA benefits. Processes benefit survivors' applications… more
- City Of Concordia (Concordia, KS)
- …liaison for the Planning Commission and the Board of Zoning Appeals preparing staff reports, providing required/requested information, and providing resultant ... required. Attendance at Planning Commission and Board of Zoning Appeals meetings may be required. JOB QUALIFICATIONS Ability to...insurance carrier. PHYSICAL DEMANDS The physical demands here are representative of those that must be met by an… more
- State of Colorado (Aurora, CO)
- …must be submitted on the official appeal form, signed by you or your representative . This form must be delivered to the State Personnel Board by email ... of notice or acknowledgement of the department's action. For more information about the appeals process, the official appeal form, and how to deliver it to the State… more
- Surgery Partners (Addison, TX)
- …preferred ESSENTIAL FUNCTIONS: Perform extensive insurance claim follow-ups for insurance denials, appeals , and perform next steps a must Ability to utilize multiple ... with payer timely filing limits Correct claims and file appeals with supporting documents to insurance companies, by phone,...responsibilities PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an… more
- CITY OF LAKE WALES (Lake Wales, FL)
- …communities. Provides staff support to the Planning & Zoning Board and Board of Appeals as needed and assigned. Confers with and advise Directors and division heads ... fax machine; tape measure. PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform… more
- City of Philadelphia (Philadelphia, PA)
- …Rights Unit, Tort Litigation Unit, Code Enforcement Unit, Labor & Employment Unit and Appeals Unit. The Civil Rights Unit represents the City of Philadelphia and its ... Communicate with and review the work of outside counsel Attend meetings as representative of the unit with other city departments and clients Analyze probable… more
- State of Colorado (Denver, CO)
- …must be submitted on the official appeal form, signed by you or your representative . This form must be delivered to the State Personnel Board by email ... of notice or acknowledgement of the department's action. For more information about the appeals process, the official appeal form, and how to deliver it to the State… more
- State of Colorado (Golden, CO)
- …review must be submitted on the official appeal form, signed by you or your representative . This form must be delivered to the State Personnel Board by email (), ... of notice or acknowledgement of the department's action. For more information about the appeals process, the official appeal form, and how to deliver it to the State… more
- Mindlance (Lewisville, TX)
- …insurance plan coverage, including out-of-pocket costs, and provide guidance on the appeals process if needed *Resolve patient's questions and any representative ... for the patient's concerns regarding status of their request for assistance *Demonstrate expertise in payer landscapes and insurance processes. Remain knowledgeable about long and short-range changes in the reimbursement environment including Medicare,… more
- State of Colorado (Littleton, CO)
- …must be submitted on the official appeal form, signed by you or your representative . This form must be delivered to the State Personnel Board by email ... of notice or acknowledgment of the department's action. For more information about the appeals process, the official appeal form, and how to deliver it to the State… more
- State of Colorado (Denver, CO)
- …must be submitted on the official appeal form, signed by you or your representative . This form must be delivered to the State Personnel Board by email ... of notice or acknowledgement of the department's action. For more information about the appeals process, the official appeal form, and how to deliver it to the State… more
- UHS (San Antonio, TX)
- …Kingdom. www.uhs.com https://laurelridgetc.com Position Summary: The Patient Account Representative interacts and coordinates with medical insurance providers to ... claims as well as underpayments from third party payers and processes appeals and/or claim(s) reconsiderations to insurance companies in a timely manner Processes… more
- EVERSANA (Mason, OH)
- …support for activities related to benefit coverage, prior authorization, claim denials, appeals , triage to third party support centers and general inquiry. ESSENTIAL ... MINIMUM KNOWLEDGE, SKILLS AND ABILITIES: The requirements listed below are representative of the experience, education, knowledge, skill and/or abilities required.… more
