- PharmaCord (Jeffersonville, IN)
- …and regional payer coverage policies, issues, coding changes, and appropriate claims submission processes Educate offices about the medical necessity requirements ... 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… more
- Stanford Health Care (Palo Alto, CA)
- …underpayments to payers + Reviewing and resolving payer rejections, denials, and performing appeals as necessary + Electronic or hardcopy claims editing and ... Health Care job.** **A Brief Overview** The Patient Account Representative (PAR) is responsible for the timely and accurate...the timely and accurate processing of insurance balance patient claims in accordance with contracts and policies. The PAR… more
- unifyCX (San Antonio, TX)
- …insurance 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… more
- AmeriHealth Caritas (Philadelphia, PA)
- …position is responsible for the administrative tasks for coordination of member and/or provider appeals , the analysis of claims and appeals , and the review ... medical management authorizations.; + Research and Investigate member and/or provider appeals and grievance requests, including review of UM/claim denial reasons,… more
- St. Luke's University Health Network (Allentown, PA)
- …of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding ... determination made by the government or commercial payors, or their auditor representative . + Facilitate clinical chart reviews to assist with supporting assigned… more
- Texas Veterans Commission (Houston, TX)
- …rulings, and state law in the adjudication process. . Prepares and files claims and appeals with supporting evidence for successful adjudication. . Advises ... Financial Operations* **Organization:** **TEXAS VETERANS COMMISSION* **Title:** *TVC - Claims Benefit Advisor (Veterans Services Representative I)* **Location:**… more
- Guidehouse (Lewisville, TX)
- **Job Family** **:** Patient Account Representative **Travel Required** **:** None **Clearance Required** **:** None **What You Will Do** **:** The **Patient Account ... Representative (PAR)** is expected to perform specific billing processes,...taking necessary actions to obtain account resolution + Submits appeals , as appropriate, for all non-clinical denials + Monitors… more
- Guidehouse (Lewisville, TX)
- **Job Family** **:** Patient Account Representative **Travel Required** **:** None **Clearance Required** **:** None **What You Will Do** **:** The **Insurance ... Patient Account Representative ** is an extension of a client's business office...from home._** **Essential Job Functions** + Account Review + Appeals & Denials + Medicare/Medicaid + Insurance Follow-up +… more
- The County of Los Angeles (Los Angeles, CA)
- …to match them with housing, and secure supportive services. + Prepares and submits appeals for claims that are denied, when justified. + Develops and submits ... VETERANS CLAIMS ASSISTANT II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/3989213) VETERANS CLAIMS ASSISTANT II Salary $55,602.72 -… more
- US Tech Solutions (Myrtle Beach, SC)
- …equivalent. + Required Work Experience: 2 years of customer service experience including 1-year claims or appeals processing OR Bachelor's Degree in lieu of work ... Performs research as needed to resolve inquiries. Reviews and adjudicates claims and/or non-medical appeals . Determines whether to return, deny or pay claims … more
- US Tech Solutions (Myrtle Beach, SC)
- … and completes adjustments and related reprocessing actions. Reviews and adjudicates claims and/or non-medical appeals . Determines whether to return, deny or ... according to department guidelines. **Responsibilities:** + Examines and processes claims and/or non-medical appeals according to business/contract regulations,… more
- Houston Methodist (Houston, TX)
- …functions, including claims resubmission to payors. + Creates and submits appeals when necessary. Engages the coding follow-up team for any medical necessity or ... At Houston Methodist, the Account Representative position is responsible for resolving all outstanding third party primary and secondary insurance claims for… more
- Sanford Health (ND)
- …40.00 **Salary Range:** $15.00 - $22.00 **Job Summary** The Insurance Representative processes and monitors unpaid third party insurance, Medicare, Medicaid or ... to work accounts throughout the entire revenue cycle. Prepares and submits claims to payers either electronically or by paper. Secures necessary medical… more
- Guidehouse (Birmingham, AL)
- …denials from payers by timely submitting all information needed to complete claims processing. The Central Denials Account Representative conducts thorough ... **Job Family** **:** Patient Account Representative **Travel Required** **:** None **Clearance Required** **:** None **What You Will Do** **:** This position will… more
- TEKsystems (Annapolis, MD)
- Job Opening: Patient Account Representative Location: Annapolis, MD Schedule: Full-time Hybrid, 3 days in office, 2 days' work from home Position Objective: * ... Performs follow-up on all third-party payer accounts receivable and appeals . * Setting up the work queues, working the...and collection, along with the revenue cycle functions of claims submission. * Acts as a liaison with patients,… more
- Rush University Medical Center (Chicago, IL)
- …liability carriers and attorneys representing the patients. + Following up on outstanding claims , including timely appeals for denied or rejected claims . ... circumstances of each case. **Summary:** A Worker's Compensation Financial Services Representative is responsible for managing the billing and reimbursement process… more
- Rochester Regional Health (Rochester, NY)
- JOB TITLE: Collections and Denials Management Representative LOCATION: SLH DEPARTMENT: Patient Financial Services Hours: 37.5 SCHEDULE: Monday-Friday 8AM-4PM ... Billing and Denials Specialist is responsible for managing the billing process, submitting claims to insurance companies, following up on unpaid or denied claims… more
- Catholic Health Services (Melville, NY)
- …the direction of the Physician Revenue Realization Manager, the Insurance Follow-Up Representative is responsible for investigating claims status with insurance ... carriers, correcting and resubmitting denied claims in the EPIC billing system. Responsibilities: + Performs...standards and procedures. + Determines reason for denial and appeals accounts as necessary. + Reviews and edits any… more
- Virtua Health (Mount Laurel, NJ)
- …insurances on a monthly basis and maintains records of declined claims requiring appeals .Position Qualifications Required / Experience Required:1-3 years ... codes, insurance information) and enters into database.Identifies and resolves denied claims , escalating accounts as necessary to ensure timely payment of … more
- Cardinal Health (St. Paul, MN)
- …as assigned in the appropriate system. + Manages and resolves complex insurance claims , including appeals and denials, to ensure timely and accurate ... done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work within the scope of responsibilities as… more
