- Accounting Now (Tampa, FL)
- The Denials Specialist performs advanced-level work related to clinical and coding denial management and appeals follow-upThe individual is responsible for ... Denials Specialists to compile appropriate documentation and medical records to submit appeals or corrected claims in a timely mannerThis position applies prior… more
- Blanchard Valley Health System (Findlay, OH)
- PURPOSE OF THIS POSITION The Denial Management Specialist is responsible for the timely review and accurate identification and follow-up of all initial denial ... as the appeal of denials/rejections from third-party payers. The specialist will manage their assigned work relating to all...to effectively reduce days in A/R. Develops and writes appeals for denials associated with the payment of claims… more
- Spectraforce Technologies Inc (Atlanta, GA)
- Title: Benefits Verification Specialist Location: Remote Duration: 3+ month's Working hours: 8:30am to 5:30pm EST or 10:30am - 7:30pm EST Note: Training shift timing ... Under general supervision of an Operations Manager, the Benefits Verification Specialist will contact insurance companies to verify patient specific benefits for… more
- Spectraforce Technologies Inc (Atlanta, GA)
- Title: Patient Access Specialist Location: Remote Duration: 3+ month's Shift timings: 8:00 am - 8:00 pm EST Job Details: Complete data entry from the enrollment form ... Under the general supervision of an Operations Manager, the Customer Access Specialist will be providing advanced services to patients, providers, and caregivers on… more
- Prestige Staffing (Houston, TX)
- An Orthopedic group in Northwest Houston is looking to hire a Billing Specialist ! Hours: Monday to Friday 8-5 Pay: dependent on years of experience and how the ... interview goes! Responsibilities: Research outstanding balances Work appeals with insurance companies more
- Dialysis Clinic, Inc. (Sacramento, CA)
- …with a lower caregiver-to-patient ratio than other providers.The AR Specialist will provide continual and accurate documentation regarding eligibility, ... accuracy as well as sending out initial claims, corrected claims and appeals .Starting pay: $23.00/hr. This position is for the California / NM… more
- Dexian - DISYS (Prairie Village, KS)
- …provided for a specific pharmaceutical product. The Benefits Verification Specialist will support the healthcare providers addressing questions regarding coding ... for Prior Authorizations (PA) for an assigned caseload and helps navigate the appeals process to access medications. Ensure cases move through the process as… more
- Accounting Now (Pinellas Park, FL)
- …Billing and Collections Specialists in St Petersburg, Florida. Billing & Collections Specialist The medical billing and collection specialist is responsible for ... Care, and commercial insurance payers. The medical billing and collection specialist must possess critical thinking skills and understanding of Medicare, Medicaid… more
- Compass Health Network (High Ridge, MO)
- …interest you, if running a Medication Clinic and acting as a case manager appeals to you! Our Compass Health Network Nursing Staff use the Compass "Champion" ... This role will actively communicate with their Clinical Doctor and Customer Relations Specialist to ensure our clients are taken care of. An Outpatient Nurse will… more
- Compass Health Network (Odessa, MO)
- …interest you, if running a Medication Clinic and acting as a case manager appeals to you! Our Compass Health Network Nursing Staff use the Compass "Champion" ... This role will actively communicate with their Clinical Doctor and Customer Relations Specialist to ensure our clients are taken care of. An Outpatient Nurse will… more
- Compass Health Network (St. Charles, MO)
- …interest you, if running a Medication Clinic and acting as a case manager appeals to you! Our Compass Health Network Nursing Staff use the Compass "Champion" ... clientele. This role will actively communicate with their Clinical Doctor and Customer Relations Specialist to ensure our clients are taken care of. This is a full… more
- Compass Health Network (St. Charles, MO)
- …interest you, if running a Medication Clinic and acting as a case manager appeals to you! Our Compass Health Network Nursing Staff use the Compass "Champion" ... clientele. This role will actively communicate with their Clinical Doctor and Customer Relations Specialist to ensure our clients are taken care of. This is a full… more
- Martin's Point Health Care (Portland, ME)
- …and external customers + Cross-trains to perform either Medicare or USFHP Appeals Specialist functions as needed Education/Experience: + Bachelor's Degree or ... other internal and external partners to ensure a comprehensive appeals management process. Job Description Specialist II...a comprehensive appeals management process. Job Description Specialist II Key Outcomes: + Serves as daily resource… more
- Carle (Urbana, IL)
- Outpatient Denial/ Appeals Specialist - RN + Department: Revenue Cycle - CFH_10_19 + Entity: Champaign-Urbana Service Area + Job Category: Clerical/Admin + ... documentation review to establish and manage clinical and prior authorization denial appeals for the Carle enterprise. Represents Carle in clinical meetings and… more
- CDPHP (Albany, NY)
- …values and invites you to be a part of that experience. The Clinical Appeals Specialist is responsible for adhering to a member/provider appeal and grievance ... Using knowledge of clinical nursing and medical practices, the Clinical Appeals Specialist will review medical necessity requests, render determinations… more
- Sutter Health (Modesto, CA)
- **Organization:** MMC-Memorial Medical Center **Position Overview:** The Grievances & Appeals Specialist supports the patient and family experience through the ... investigation of patient/family complaints, concerns, and other feedback received by the organizations. Complaints and grievances include, but are not limited to, the care provided by physicians and other health care professionals, potential liability, quality… more
- University of Utah (Salt Lake City, UT)
- …Number** PRN39530B **Job Title** Outpatient/Provider Coder Level 3 **Working Title** Medical Appeals Coding Specialist SR **Job Grade** E **FLSA Code** Nonexempt ... Coder-Hospital ( CPC -H), Certified Professional Coder-Payer ( CPC -P), Certified Coding Specialist ( CCS ), Certified Coding Specialist - Physician Based (… more
- Area Agency On Aging 1-b (Southfield, MI)
- The Appeals and Compliance Specialist is responsible for providing comprehensive responses in compliance with contract, regulatory and accreditation requirements ... information and communicate disposition of case . + Triages case inquiries, appeals , and prepares case files/packets for appeal hearings. Attend State Fair Hearings… more
- Generac Power Systems (Waukesha, WI)
- …into an energy technology solutions company, we continue to push new boundaries. The ** Appeals and Grievances Specialist ** is a critical team player who is ... under general supervision with some guidance from leadership and higher-level Appeals and Grievances Specialists. **Job Responsibilities:** Case Resolution + Handles… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II (ALD) Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los ... achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will...Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve member and… more
