- LA Care Health Plan (Los Angeles, CA)
- Manager, Customer Solution Center Appeals and Grievances Job Category: Management/Executive Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, ... to achieve that purpose. Job Summary The Manager, Customer Solution Center Appeals and Grievances is responsible for the centralized intake, logging and triage… more
- St. Luke's University Health Network (Allentown, PA)
- …The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all diagnosis and procedure codes to ... determination made by the government or commercial payors, or their auditor representative . + Facilitate clinical chart reviews to assist with supporting assigned… more
- St. Luke's University Health Network (Allentown, PA)
- …health care. The Coding Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all diagnosis and procedure codes to ... AMA CPT, are assigned to support the services/treatment rendered. The Coding Appeals Specialist also prepares appeal arguments and/or letters to support and defend… 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 ... and efficiencies are met. -The ability to query, analyze data , and map detailed processes coupled with analytical skills...Requirements:** -The physical and mental demands described here are representative of those that must be met by an… more
- MyFlorida (Orlando, FL)
- 855772 - EMPLOYMENT SECURITY REPRESENTATIVE II - 40034030 Date: Jul 2, 2025 The State Personnel System is an E-Verify employer. For more information click on our ... 855772 Agency: Commerce Working Title: 855772 - EMPLOYMENT SECURITY REPRESENTATIVE II - 40034030 Pay Plan: Career Service Position...to apply the law in making initial determinations on claims . The individual in this position must be able… 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 ... payer, system or escalated account issues. + May maintain data tables for systems that support PB Claims... data tables for systems that support PB Claims operations. + Evaluate carrier and departmental information and… 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
- Robert Half Accountemps (Edina, MN)
- Description We are looking for a dedicated Patient Account Representative to join our healthcare team in Edina, Minnesota. This long-term contract position offers an ... medical billing systems, including Epic Software and Cerner Technologies, to process claims and manage account records. * Ensure accurate documentation of patient… more
- Robert Half Accountemps (Omaha, NE)
- …+ Utilizes systems to resolve customer needs such as appointments authorizations claims invoices eligibility benefits appeals TARs + Translates oral information ... Description Robert Half is Seeking a Member Service Representative to join our cutting edge healthcare client's...and external customer + Multi-task utilizing double monitors for data entry phone etiquette and use of resources while… more
- Owens & Minor (Columbus, OH)
- …The collections representative follows-up with insurance companies to resolve unpaid claims . The anticipated hourly range for this position is $12.21 - $17.04. ... customers on delinquent payments. + Reviews unpaid and underpaid claims . Resubmits or appeals as necessary. +...a strong ability to understand, interpret and develop spreadsheet data . **Other Skills** **PHYSICAL DEMANDS** This is a stationary… more
- Robert Half Office Team (Minneapolis, MN)
- Description We are looking for a dedicated Customer Service Representative to join our team on a long-term contract basis in Minneapolis, Minnesota. In this role, ... Assist patients with scheduling appointments, understanding healthcare benefits, and navigating claims processes. * Support internal teams by managing paperwork and… more
- Banner Health (AZ)
- …activities in one or more assigned areas of billing, payment posting, collections, payor claims research, and other accounts receivable work. We work as a team to ... Office programs, Banner Systems (MS4, CERNER, FinThrive collections, Nthrive claims ) **Schedule:** Monday-Friday 8:30am-5pm AZ Time **Ideal** **Candidate:** +… more
- Robert Half Accountemps (Alamogordo, NM)
- …+ Utilizes systems to resolve customer needs such as appointments authorizations claims invoices eligibility benefits appeals TARs + Translates oral information ... every internal and external customer + Multi-task utilizing double monitors for data entry phone etiquette and use of resources while maintaining proper guidelines… more
- Robert Half Office Team (Dodge City, KS)
- …Use internal systems to manage customer needs such as appointments, authorizations, claims , invoices, eligibility benefits, and appeals . Accurately document and ... and external customers . Manage multi-tasking tasks using dual monitors, including data entry and phone etiquette, while maintaining compliance with guidelines .… more
- Independent Health (Buffalo, NY)
- …the collection and review of medical records specific to quality complaints/grievances and appeals as indicated in support of a high performing health plan and ... network. The Clinical Reviewer will investigate quality complaints/grievances and appeals , document research of initial coverage determinations, and lead… more
- State of Colorado (Denver, CO)
- …employment laws; responding to grievances, equal Employment Opportunity Commission (EEOC) claims , appeals , charges of discrimination; settlement advice; benefits ... laws; progressive discipline; records management; recruitment; responding to grievances, appeals , charges of discrimination; reorganization issues; retention; selection and… more
- MyFlorida (Orlando, FL)
- …(relocation benefits are not available for this position) OPS Employment Security Representative II This position will be used for multiple vacancies OPEN ... The Work You Will Do: This is an OPS Employment Security Representative II- Employment Review Specialist position in the Department of Commerce's Reemployment… more
- LogixHealth (Dania Beach, FL)
- …follow-up experience in professional healthcare billing + Familiarity with payer regulations, claims appeals processes, and denial reasons + Proficiency in EHR ... of benefits (EOB) statement + Review A/R (Accounts Receivable) reports to follow up on unpaid claims + Prepare and submit out appeals on claims that require… more
- Ryder System (Atlanta, GA)
- …Processor support processes which includes claims filing, overseeing and ensuring claims reject processing, 4-15 ( claims appeals ) processing, Additional ... will implement and follow standard warranty procedures and manage claims process for 50K to 75K claims ...They are responsible to ensure the communication of warranty data to OEM's for New Vehicle Warranty while improving… more
- State of Colorado (Denver, CO)
- …is reached. + Assist in organizing and translating work unit program expenditures and claims data into datasets for financial reporting and analysis. Format and ... to the Medical Services Section. It performs routine tasks such as data entry, recordkeeping, invoice processing, scheduling, and document preparation. + Ensures… more
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