- VNS Health (Manhattan, NY)
- …of Liability form, follows-up and tracks receipt. Prepares letters requesting Appointment of Representative (AOR) forms in grievances and appeals filed on behalf ... including intake, classification, setup, and assignment of grievances and appeals . Additionally, provides administrative support to staff, including tasks such… more
- Fallon Health (Worcester, MA)
- …on Facebook, Twitter and LinkedIn. **Brief summary or purpose:** Fallon Health (FH) Appeals and Grievance process is an essential function to FH's compliance with ... standards, other applicable regulatory requirements and member expectations. The FH Member Appeals and Grievance Intake Administrator serves to administer the FH … more
- Point32Health (MA)
- …colleagues and communities. **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Member Appeals and Grievance Analyst ... the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual works… more
- Penske (Reading, PA)
- …audits, including negotiating with auditors and interfacing with taxing jurisdictions. -Perfect appeals and refund claims. -The position will require the ability to ... are required. **Physical Requirements:** -The physical and mental demands described here are representative of those that must be met by an associate to successfully… 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
- Surgery Care Affiliates (Boise, ID)
- …change. If you join our team, they will. Responsibilities The Patient Account Representative will be responsible for thorough and timely patient account follow up ... manages second level reimbursement issues, contracted and non-contracted denials and appeals . + This is a demanding environment, which requires attention to… more
- RWJBarnabas Health (Oceanport, NJ)
- Patient Accounts Representative ,Full-Time, Day ShiftReq #:0000197635 Category:Billing/Collections/Registration Status:Full-Time Shift:Day Facility:RWJBarnabas ... Health Corporate Services Department: Appeals Location: System Business Office, 2 Crescent Place, Oceanport,...Place, Oceanport, NJ 07757 Job Summary: The Patient Accounts Representative position supports the reduction of Accounts Receivables. The… more
- Independent Health (Buffalo, NY)
- …paid time off (PTO), including company paid holidays. The Provider Relations Representative position offers an opportunity to begin a career at Independent Health. ... the office depending on business needs. **Overview** The Provider Relations Representative will be responsible for assisting our provider constituents and providing… more
- TAD PGS, Inc. (Chicago, IL)
- …employee grievance and disciplinary matters. + Oversees matters related to the Employee Appeals Board and acts as Representative of the Employee Appeals ... Board. + Counsels various departments and offices in labor relations and employment matters such as discipline, layoffs, terminations, transfers, and numerous other matters that may arise between management and employees/unions. + Provides advice and counsel… 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
- MVP Health Care (VT)
- Professional, Provider Relations Representative Plattsburgh, NY, USA * Vermont, USA Req #2356 Friday, January 24, 2025 At MVP Health Care, we're on a mission to ... improvement. To achieve this, we're looking for a **Professional, Provider Relations Representative ** to join #TeamMVP. If you have a passion for collaboration and… 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
- TEKsystems (Philadelphia, PA)
- As the AR Follow Up Representative If you're ready to explore the next step in your career: You'll enjoy Career Opportunities - Tons of growth opportunities for your ... or underpaid claims and resolving the denial and filing appeals , as necessary. + Ensuring all information pertaining to...and Strengths: AR Follow-Up | AR Specialist | Follow-Up Representative | Insurance Authorizations | ICD-10 Codes | CPT… more
- Guidehouse (Lewisville, TX)
- **Job Family** **:** Patient Account Representative **Travel Required** **:** None **Clearance Required** **:** None **What You Will Do** **:** The **Insurance ... Patient Account Representative - Hospital A/R Emphasis** is an extension of...Job Functions** + Hospital Claims + Account Review + Appeals & Denials + Medicare/Medicaid + Insurance Follow-up +… more
- Concentrix (Albuquerque, NM)
- Job Title: Customer Service Representative (Healthcare) - Remote Job Description The Customer Service Representative (Remote) works from home and interfaces with ... insurance related needs. Examples include: Inquiries regarding benefits, eligibility, appeals , grievances and troubleshooting medical devices. All while providing a… more
- New York State Civil Service (Albany, NY)
- …rules, regulations and case law. The incumbent serves as the Chancellor's representative in hearing appeals of disciplinary and contract grievances pursuant ... policy for classified service employees.- Serves as the University's representative in the administration of the grievance procedures (contract, non-contract… more
- CVS Health (Columbus, OH)
- …EST Time Zone. Responsibilities below include, but not limited to: -Customer Service Representative is the face of Aetna and impacts members' service experience by ... new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system. -Educates providers on our self-service… more
- CVS Health (Oklahoma City, OK)
- …customer-focused professionals supported by exemplary technologies and processes. Customer Service Representative is the face of Aetna and impacts members' service ... referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system. + Educates providers on our… more
- CVS Health (Austin, TX)
- …Texas, CST. Responsibilities below include, but not limited to: + Customer Service Representative is the face of Aetna and impacts members' service experience by ... referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system. + Educates providers on our… more
- CVS Health (Tallahassee, FL)
- …in the east, central, mountain, pacific** **time zones** * The Customer Service Representative is the face of Aetna and impacts members' service experience by manner ... referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system. * Educates providers on our… more
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