- 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 ... in accordance with CMS requirements + Cross-trains with US Family Health Plan Appeals Specialist to perform functions as needed US Family Health Plan Focus Key… more
- HCA Healthcare (Nashville, TN)
- …**Introduction** Do you want to join an organization that invests in you as an Appeals Specialist ? At Parallon, you come first. HCA Healthcare has committed up ... have the opportunity to make a difference. We are looking for a dedicated Appeals Specialist like you to be a part of our team. **Job Summary and… more
- Universal Health Services (Richmond, VA)
- …The Atlantic Region CBO is seeking a dynamic and talented Senior Appeals Specialist . The Senior Appeals Specialist ... identified during the billing of claims and the follow-up on the clinical appeals performed by the facilities. Key Responsibilities include: + Responsible for higher… 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 ... identified during the billing of claims and the follow-up on the clinical appeals performed by the facilities. Key Responsibilities include: + Responsible for … more
- Natural Resources Conservation Service (Champaign, IL)
- Summary The incumbent serves as an mid-level Appeals Specialist responsible for program management support of the conservation quality assurance and the ... administrative appeals process involving NRCS in the assigned state working...primary point of contact in the state for programmatic appeals dealing with conservation programs and conservation compliance provisions… 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 ... location in **Plano, TX** currently has an opportunity for a **Sr. Appeals Specialist ** . This role is responsible for facilitating and assisting Abbott patients… 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 ... in compliance with Managed Care contracts and government fee schedules. The Appeals Specialist will obtain, manipulate, and analyze data from a variety of… 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
- Idaho Division of Human Resources (Boise, ID)
- APPEALS TAX SPECIALIST Posting Begin Date: 2024/06/07 Posting End Date: 2024/06/21 Category: Accounting and Finance Sub Category: Tax Administration Work Type: ... Rate Type: Hourly Description State of Idaho Opportunity The Idaho State Tax Commission Appeals Unit is seeking applicants with knowledge in Income Tax to fill an… 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, ... achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will...Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve member and… more
- University of Virginia (Charlottesville, VA)
- …+ Works complex denials with a high degree of accuracy and timeliness. Responds to inquiries from patients, clinical departments, and third parties by way of ... telephone, written correspondence and personal contacts. + Adds/corrects registration, insurance, and demographic data in the EPIC billing system to ensure accurate records. + Analyzes and prepares applicable adjustments to physicians' fees in compliance with… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Quality Auditing Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: ... achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Quality Auditing (QA) Specialist ...Center Appeals and Grievances Quality Auditing (QA) Specialist II is responsible for assisting the Appeal and… more
- Alight (IL)
- …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 resolve… more
- Sanford Health (Sioux Falls, SD)
- …interpretation of policies, and handling of correspondence related to denials and appeals submitted by providers and members. Must administer benefits in accordance ... demonstrated understanding of regulatory requirements and timeframes. Intake and coordinate appeals and denials, and then make determinations based on member policy… more
- Internal Revenue Service (Fresno, CA)
- …CAREERS? Visit us on the web at www.jobs.irs.gov Responsibilities WHAT IS THE APPEALS DIVISION? A description of the business units can be found at: ... Vacancies will be filled in the following specialty areas: Office of Appeals Case and Operations Support Account and Processing Support Special Programs AARS… more
- TEKsystems (Plano, TX)
- Required: + 2+ years of Insurance follow-up, denials/ appeals experience (Medical A/R) + Hospital/facility collections experience Description: Responsible for A/R, ... Responsible for managing CBO Aging Report properly to insure appeals are followed up timely to prevent past filing...Responsible for timely medical records requests and submission of appeals * Maintain adequately trained staff to achieve daily… 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
- 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 ... knowledge of state/federal laws as they relate to contracts and the appeals process. Investigates and addresses overpayment and underpayment accounts with the… 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 reviews findings with all level of Payment Resolution Specialist for further review. Takes initiative to continuously learn… more
- Johns Hopkins University (Middle River, MD)
- …edits reports, file or pull EOB batches. + Identifies and escalates non-standard appeals to a higher-level specialist . + Informs the supervisor / Production ... for the basic collection of unpaid third-party claims and standard appeals , using various JHM applications and JHU/ PBS billing applications. Communicates… more