- Mount Sinai Hospital (New York, NY)
- Job Description Remote Medical Staff Services Health Care Specialist (Delegation/Enrollment) The Medical Staff Services Health Care Specialist is responsible for ... Interaction with plan representatives regarding enrollment audits; problems and claims resolution; identify fee schedule issues; and addressing potential corrective… more
- Baptist Memorial Health Care Corporation (Memphis, TN)
- …activities related to denied claims such as obtaining authorizations, claims review, patient billing, appeal writing, auditing , and/or denial management; ... Overview Specialist -Denial Mitigation II RN Job Code : 21432...collaborate with coding/billing for formulation of appeal with corrected claims and denial resolution in order to defend our… more
- Children's Wisconsin (Milwaukee, WI)
- …Remote What You Will Do: Responsible for researching, analyzing, monitoring and auditing charging and billing processes, quality of documentation to support ... on teams assembled to respond to government and commercial audits of claims ; facilitates submission of records and resolution as needed and maintains documentation.… more
- Axis (Alpharetta, GA)
- …upon request for candidates taking part in the selection process. **Job Description: Senior Claims Specialist ** AXIS is seeking a Senior Claims Specialist ... Claims team reporting to the Manager of Casualty Claims . This position requires senior claims management...plus. **What will you do in this role?** + Auditing of Third-Party Administrators to ensure reserve adequacy. +… more
- Walgreens (Deerfield, IL)
- **Job Description:** **Job Summary :** Responsible for the update, maintenance, auditing , and operation of third party prescription plans including Commercial, ... and Audits, Prescriber and prescriptive authority tickets, proper processing of prescription claims including order of claims processing for government payers.… more
- NC Department of Transportation (Wake County, NC)
- Compliance Specialist Temp Print (https://www.governmentjobs.com/careers/northcarolina/jobs/newprint/5010966) Apply Compliance Specialist Temp Salary $20.00 - ... of claim reimbursements for accuracy as part of our internal self- auditing process; assisting with monthly, quarterly, semi-annual, and annual reporting… more
- Novant Health (NC)
- …Full time with benefits What You'll Do: + The Coding Audit Response Specialist position responds to external and internal audits for OUTPATIENT SURGERY services that ... for all applicable Novant Health facilities. + The Coding Audit Response Specialist will support the Corporate Coding Audit Response Lead/Coding Supervisor by… more
- Novant Health (NC)
- …Full time with benefits What You'll Do: + The Coding Audit Response Specialist position responds to external and internal audits for INPATIENT services that include ... for all applicable Novant Health facilities. + The Coding Audit Response Specialist will support the Corporate Coding Audit Response Lead/Coding Supervisor by… more
- University of Utah (Salt Lake City, UT)
- Details **Open Date** 05/13/2025 **Requisition Number** PRN41889B **Job Title** Compliance Specialist **Working Title** Compliance Specialist **Job Grade** E ... at any time)** **Job Summary** Provides compliance related coding reviews and auditing of faculty and physician documentation. The position will utilize coding… more
- MyFlorida (Gainesville, FL)
- INVESTIGATION SPECIALIST II - 79001410 Date: Jul 29, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... No: 857645 Agency: Business and Professional Regulations Working Title: INVESTIGATION SPECIALIST II - 79001410 Pay Plan: Career Service Position Number: 79001410… more
- C&W Services (New York, NY)
- **Job Title** HSSE Regional Specialist **Job Description Summary** POSITION SUMMARY The Environmental Health & Safety (EH&S) Manager is responsible for providing ... report and manage the corrective actions * Support Workers Compensation (WC) claims tracking, investigation, and management process * Liaise with WC Program Manager… more
- Independent Health (Buffalo, NY)
- …fosters growth, innovation and collaboration. **Overview** The Clinical & Coding Specialist -Senior will be responsible for reviewing coding and clinical decisions on ... proficiency demonstrated by long-standing, consistent results, advanced coding knowledge and auditing skills evidenced by their ability to train others, to identify… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Appeals Specialist II will be responsible for the initial analysis of appeals/grievance correspondence, and determination ... FUNCTIONS:** + Independently researches contractual benefits, limitations & exclusions and claims to assist medical professional staff in performing the review of… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Remote Medical Staff Services Health Care Specialist (Delegation/Enrollment)** The Medical Staff Services Health Care Specialist is ... + Preferred experience in health plan Provider Relations and/or Health Plan auditing setting, or within a hospital?s Delegated Enrollment or Managed Care Enrollment… more
- Publix (Lakeland, FL)
- …Lakeland **Department:** Finance **Location:** Lakeland, FL **Description:** The Senior Collections Specialist - Pharmacy focus on collections, auditing , and ... + Responsible for managing and improving the aging report on unpaid pharmacy claims , collecting money for all pharmacy 3rd party sales receivables, as well as… more
- St. Luke's University Health Network (Allentown, PA)
- …of a patient's ability to pay for health care. The Coding Appeals Specialist retrospectively reviews patient medical records, claims data and coding of ... CPT, are assigned to support the services/treatment rendered. The Coding Appeals Specialist also prepares appeal arguments and/or letters to support and defend the… more
- Robert Half Accountemps (Nashua, NH)
- Description Nashua, NH - ON-SITE - Patient Access Specialist - 3rd Shift Position Hours 11:00am-7:00pm - Multiple Openings We are looking for a dedicated Patient ... Access Specialist to join our team in Nashua, New Hampshire....input benefit data to support billing processes and enhance claims accuracy. * Utilize software tools to identify potential… more
- Dairy Farmers of America (Kansas City, KS)
- **Job Description** The Sr. Compliance Specialist - Labeling is responsible for auditing labels to ensure they comply with regulations and internal policies, ... information, product formulation, marketing materials, ingredient statements, and product claims to ensure proper documentation and compliance with applicable… more
- McLaren Health Care (Shelby Township, MI)
- **Position Summary** : The Underpayment Specialist is responsible for performing audits of patient accounts to identify inaccurately under adjudicated accounts by ... staff to identify process improvements that will allow payers to adjudicate claims per their associated contract. Underpayment Specialists will work with minimal… more
- Wabtec Corporation (Bloomington, CA)
- …on various days as required, including having a flexible work schedule to perform auditing and training on various shifts. * The ability to maintain reliable and ... locomotives? That's ok! We provide in-depth technical training to give our materials specialist the knowledge and expertise needed to be successful. What will your… more
