- 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 ... a focus on automation, talent enablement, strategic partnerships, and strict data ethics, UnifyCX delivers scalable, personalized, and compliant solutions that… 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
- 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
- Access Dubuque (Dubuque, IA)
- …Jobs** Client Service Representative Cottingham & Butler/ SISCO Service Representative Express Employment Professionals Claims Representative Cottingham ... Member Services Representative **Medical Associates** 1 Positions ID: o6fSxfwu Posted...employee benefit plans offered + Interpret and enter necessary data and documentation into member and authorization subsystems of… 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 . ... experience and skills, as well as internal equity and industry specific market data . The pay range for each role reflects Rush's anticipated wage or salary… 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
- US Anesthesia Partners (Austin, TX)
- …without a reasonable accommodation) + Contacts insurance companies for status on outstanding claims . + Processes and follows up on appeals to insurance ... Overview The Accounts Receivable Representative III is responsible for collecting outstanding accounts...Provides peer payer and system training support. + Gathers data and reports out in partnership with leadership. +… 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
- US Anesthesia Partners (Austin, TX)
- …without a reasonable accommodation) + Contacts insurance companies for status on outstanding claims . + Process and follow up on appeals to insurance companies. ... Overview The Accounts Receivable Representative I is responsible for collecting outstanding accounts...Knowledge of managed care, Medicare, and Medicaid guidelines. + Data entry skills with high accuracy. + Knowledge of… more
- CVS Health (Frankfort, KY)
- …are handled within a timely manner. Staff may be responsible for reviewing claims data and information. The Senior Network Relations Analyst is responsible ... + Oversees Access & Availability monthly monitoring process. + Responsible for reviewing claims data in QNXT when provider's inquiry involves claims … more
- Banner Health (WY)
- …activities in one or more assigned areas of billing, payment posting, collections, payor claims research, and other accounts receivable work. Works as a member of a ... CORE FUNCTIONS 1. May be assigned to process payments, adjustments, claims , correspondence, refunds, denials, financial/charity applications, and/or payment plans in… more
- University of Rochester (Fairport, NY)
- …edits, and obtains signatures for non-routine letters of correspondence related to appeals on denied claims , including compiling all necessary information and ... determined by considering factors including, but not limited to, market data , education, experience, qualifications, expertise of the individual, and internal equity… more
- University of Rochester (Rochester, NY)
- …protocols in selecting for routine and non-routine letters of correspondence related to appeals on denied claims , billing and patient communications. + This ... determined by considering factors including, but not limited to, market data , education, experience, qualifications, expertise of the individual, and internal equity… 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
- 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 ... the Department of Justice. The CTA is DLA's lead representative before the ASBCA. The CTA represents DLA in...litigating cases before the Armed Services Board of Contract Appeals , Court of Federal Claims , and Government… more
- MyFlorida (Tallahassee, FL)
- …(relocation benefits are not available for this position) OPS Employment Security Representative II This position will be used for multiple vacancies. OPEN ... issues and the chargeability of employer accounts for benefit payments on claims . This may be accomplished telephonically, through written correspondence, or through… more
- State of Colorado (Denver, CO)
- …Coloradans. What we do: Retail Operationsprovides the sale of Lottery products, claims processing, redemption of prizes, and customer service at the Pueblo, Denver, ... Grand Junction, and Ft. Collins Claims Counters, including providing customer service support to retailers,...from many levels within the organization and community. + Data Entry including: entering information into a program or… more
- University of Rochester (Rochester, NY)
- …the individual, and internal equity considerations._ **Responsibilities:** GENERAL PURPOSE The claims resolution representative II is responsible for working ... include but are not limited to researching, correcting, resubmitting claims , submitting appeals and taking timely and...and taking timely and routine action to resolve unpaid claims . The Claims Resolution Representative … more
- NJM Insurance (Hammonton, NJ)
- …legal proceedings as appropriate. + Collaborate and communicate cross-departmentally regarding claims and appeals handling related to pending litigation. ... NJM's General Claims Legal department is seeking a PIP Appeal...Job Responsibilities: + Review, evaluate and process incoming Pre-Litigation Appeals in accordance with the PIP Internal Appeal Procedures.… more
- State of Colorado (Denver, CO)
- …dose cassettes). + Issues credits back to clients. + Process Medicare Part D claims . + Completes associated paperwork and computer data entry. Package and Fill ... of inventory for (near) outdated medication for removal and replacement, data entry, ordering and restocking pharmaceuticals and supplies, pre-packaging and labeling… more
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