- PharmaCord (Jeffersonville, IN)
- …for coverage and provide education support for the office to submit pre-determinations, appeals and/or peer to peer reviews with payors, as applicable Assist offices ... to understand payor denied or underpaid claims and provide education, as applicable, for the office to resolve of rejected, denied or underpaid claims Educate HCPs, their office staff and/or patients on appropriate resources for questions about co-pay,… more
- Stanford Health Care (Palo Alto, CA)
- …is a Stanford Health Care job.** **A Brief Overview** The Patient Account Representative (PAR) is responsible for the timely and accurate processing of insurance ... - Payer clerical and technical denial review and request processing including basic appeals - Payment posting and batch reconciliation - Credit balance review and… more
- Commonwealth Care Alliance (Boston, MA)
- …members and all those involved in CCA members' care. The Member Service Representative (MSR) is responsible to provide a best-in-class service experience to all ... timely resolution of concerns or complaints conveyed by members and their representative . - Conduct research to provide accurate and informed resolution to members… more
- unifyCX (San Antonio, TX)
- …industry (preferred but not required). What Will You Do? Take ownership of appeals and claims, investigating and analyzing each case to determine the best path ... forward. Communicate policy guidelines and decisions to customers with clarity, empathy, and professionalism. Collaborate with the team to resolve complex cases and maintain seamless case management. Balance customer satisfaction with policy compliance,… more
- Tutor Perini (New York, NY)
- …or in the future Frontier-Kemper-Tutor Perini joint venture is seeking a **Safety Representative ** to join our Manhattan Tunnel Project in New York, New York. ... facility. **_Extraordinary Projects Need Exceptional Talent_** As a **Safety Representative ** at Frontier-Kemper-Tutor Perini joint venture, reporting to the… more
- Universities of Wisconsin (Whitewater, WI)
- …accommodations for students with disabilities and serve as University Housing representative on the accommodations committee for CSD. Work collaboratively with ... complicated and sensitive housing-related issues, policy questions, requests, and appeals , including matters related to student resident disabilities and gender… more
- Warren Equipment Company (Tulsa, OK)
- …facility operations with project objectives while deferring permitting and municipal appeals to the Project Managers. . Inspect construction and installation ... of electrical shock. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions… more
- Robert Half Legal (Nashville, TN)
- Description We are seeking an Appeals Litigation LEGAL ASSISTANT Representative for the Appeals Operations Group within Member Services. The Appeals ... LEGAL ASSISTANT Representative will work to resolve appeals prior to hearing by identifying appeals ...assist in the processing of appeals . The Appeals Litigation LEGAL ASSISTANT Representative will document… more
- State of Colorado (Denver, CO)
- …review must be submitted on the official appeal form, signed by you or your representative . Appeals to the State Personnel Board or the State Personnel Director ... monitoring, tobacco prevention, grant program implementation, public health project representative , program operations, commissioned officer, retail compliance implementation, or… more
- State of Colorado (Denver, CO)
- …review must be submitted on the official appeal form, signed by you or your representative . Appeals to the State Personnel Board or the State Personnel Director ... must be received or postmarked within the filing period: Appeals shall be filed with the Board no later...### Email filings: dpa_###@state.co.us For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (Denver, CO)
- …review must be submitted on the official appeal form, signed by you or your representative . Appeals to the State Personnel Board or the State Personnel Director ... must be received or postmarked within the filing period: Appeals shall be filed with the Board no later...### Email filings: dpa_###@state.co.us For more information about the appeals process, the official appeal form, and how to… more
- AmeriHealth Caritas (Philadelphia, PA)
- …about us at www.amerihealthcaritas.com. **Responsibilities:** Reporting to the Supervisor, Appeals and Grievances, this position is responsible for the ... administrative tasks for coordination of member and/or provider appeals , the analysis of claims and appeals ,... system and documents, all correspondence with a member/participant, representative and/or a provider, related to an appeal or… more
- St. Luke's University Health Network (Allentown, PA)
- …a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all ... determination made by the government or commercial payors, or their auditor representative . + Facilitate clinical chart reviews to assist with supporting assigned… more
- Ochsner Health (New Orleans, LA)
- …status. **Physical and Environmental Demands** The physical demands described here are representative of those that must be met by an employee to successfully ... perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Medium Work - Exerting 20 to 50 pounds of force occasionally, and/or 10 to 25 pounds of force… more
- HANAC, Inc. (Astoria, NY)
- …integral part of a team with the immigration attorney, Board of Immigration Appeals (BIA) accredited representative , and support staff. The Immigration Paralegal ... will assist the staff attorney and the Program Director in providing legal services, education, and outreach, including coordination of community events, and working under attorney supervision to assist clients on Immigration law matters. The Paralegal will… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Account Representative position is responsible for resolving all outstanding third party primary and secondary insurance claims for ... billing functions, including claims resubmission to payors. + Creates and submits appeals when necessary. Engages the coding follow-up team for any medical necessity… 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
- Whidbey General Hospital (Coupeville, WA)
- JOB SUMMARY The Patient Financial Services Representative supports the mission of providing quality healthcare to the patients of WhidbeyHealth by performing a ... support the financial health and well-being of the organization. The PFS Representative may be responsible for coordinating patient referrals and subsequent follow… more
- Defense Logistics Agency (Fort Belvoir, VA)
- …or decisions. The CTA is vital to ensure that there is always a centralized representative on all active appeals even as other Government counsel are assigned ... of cases before the Armed Services Board of Contract Appeals , Contract Disputes Act, and procurements falling under the...the Department of Justice. The CTA is DLA's lead representative before the ASBCA. The CTA represents DLA in… more
- Guidehouse (Birmingham, AL)
- **Job Family** **:** Patient Account Representative **Travel Required** **:** None **Clearance Required** **:** None **What You Will Do** **:** This position will ... information needed to complete claims processing. The Central Denials Account Representative conducts thorough account reviews to determine the appropriate action… more
