- 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 ... 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
- Texas Veterans Commission (Victoria, 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
- University of Rochester (Rochester, NY)
- …expertise of the individual, and internal equity considerations._ **Responsibilities:** The Claims Resolution Representative II is responsible for working across ... collection. Responsibilities include but are not limited to researching, correcting, resubmitting claims , submitting appeals and taking timely and routine action… more
- Humana (Madison, WI)
- …and help us put health first** Humana/iCare is seeking a Call Center and Claims Representative to meet the needs of members, potential enrollees and providers ... claims , and perform other duties as assigned. The Call Center and Claims Representative works in a call center setting and provides program, benefit,… more
- Guidehouse (Lewisville, TX)
- …San Antonio office and three days from home._** **Essential Job Functions** + Hospital Claims + Account Review + Appeals & Denials + Medicare/Medicaid + ... **Job Family** **:** Patient Account Representative **Travel Required** **:** None **Clearance Required** **:**...+ 1+ year's medical provider experience working with UB04, appeals & denials. + Hospital or EOB claims… more
- TEKsystems (Phoenix, AZ)
- …Required Skills & Abilities: + Minimum of 2 years of Supplemental Health or Medical claims experience required. + Minimum of 2 years of experience in a call center ... environment, within the health/medical insurance claims industry. + Previous experience with HFCA 1500 &...complaint requests to identify and classify member and provider appeals . + Determine eligibility, benefits, and prior activity related… 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
- 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
- Archbright (Seattle, WA)
- …Lead in Making a Real Impact. Join Archbright as a Workers' Compensation Claims Consultant Are you an experienced workers' compensation professional with a passion ... name in workplace performance and compliance, is looking for a Workers' Compensation Claims Consultant to join our dedicated team. You'll be part of an organization… 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 ... companies to ensure payments are processed correctly. + Manage and resolve outstanding claims or accounts in a timely manner. + Achieve cash collection metrics and… more
- TEKsystems (Philadelphia, PA)
- …Core Experience: + AR Follow Up Experience (2-5 years) + EPIC + Working Denials + Claims Appeals + Home Health Claims *huge plus* Pay and Benefits The ... As the AR Follow Up Representative If you're ready to explore the next...no response. Reviewing denied claims or underpaid claims and resolving the denial and filing appeals… more
- Guidehouse (Birmingham, AL)
- …as needed or sending to appropriate department for review. Follow up on authorizations, claims and appeals with payers. Interact with other departments and work ... **Job Family** **:** Patient Account Representative **Travel Required** **:** None **Clearance Required** **:** None **What You Will Do** **:** The Central Denials… 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
- Jennie Stuart Medical Center, Inc. (Hopkinsville, KY)
- Responsible for correctly processing healthcare claims to obtain reimbursement to various third party payers and patients, ensuring proper account documentation in ... corrects both internal errors and denials from insurance companies and re-files claims . Reviews, evaluates, and forwards manual patient account statements to payers… more
- Fairview Health Services (St. Paul, MN)
- …process. + Daily work queues are at zero + Correspondence worked daily + Timely claims processing and timely appeals Demonstrate a high degree of proficiency in ... issue resolution. Mentors and trains staff in the PFS Representative 1 and 2 positions. Maintains the best practice...and PFS management in user acceptance testing. + Screens claims on-line or on paper for accuracy and obtain… 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
- UNC Health Care (Chapel Hill, NC)
- …**Job Responsibilities:** + Responsible for the accurate and timely submission of claims follow up, reconsideration and appeals , response to denials, and ... a variety of complex duties, including but not limited to, working outstanding insurance claims follow up for no response from payors, and/or claim denials. + Works… 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 ... achieve this, we're looking for a **Professional, Provider Relations Representative ** to join #TeamMVP. If you have a passion...triaged provider issues including (but not limited to): + Claims Inquiries + Payment Inquiries + Recovery Inquiries +… more
- Sacramento County (Sacramento, CA)
- Utility Billing Services Representative Level I/II Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/4919510) Apply Utility Billing Services ... Representative Level I/II Salary $45,518.40 - $62,744.40 Annually Location...Street, Room 2640, Sacramento, CA 95814, telephone: ###. Such appeals must be filed within thirty (30) calendar days… more
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