- PharmaCord (Jeffersonville, IN)
- …A typical day in the life of a Medical Billing and Coding Specialist will include the following: The responsibilities include, but are not limited to ... and regional payer coverage policies, issues, coding changes, and appropriate claims submission processes Educate offices about the medical necessity requirements… more
- PharmaCord (Cincinnati, OH)
- …PharmaCord Lynk system, maintaining detailed records of reimbursement activities, including claims status, payments, and appeals . Generate reports and analysis ... includes completing benefit investigations, tracking prior authorizations / denial appeals , and assisting patients or other callers/stakeholders through resolution… more
- Lincoln Financial (Denver, CO)
- …for this opportunity. **Requisition #:** 74565 **The Role at a Glance** As an Appeals Specialist you will be responsible for being a product subject matter ... multiple product lines. You will perform and deliver on appeals claims assignments/projects while simultaneously leveraging and...lieu of Bachelor's) + 1 - 3+ Years of Short -Term and/or Long-Term Disability. (Required) + Ability to communicate… more
- Cognizant (Juneau, AK)
- **Provider Appeals & Grievances Specialist ** (remote) This is a remote position open to any qualified applicant that lives in the United States. **Summary:** We ... are seeking a dedicated Provider Appeals & Grievance Specialist with 1 to...and state Medicaid policies. **Qualifications/Skills Needed:** 1-2 years of Appeals and Grievance 1 yr. medical claims … more
- Actalent (Dallas, TX)
- …disputes, grievances, and complaints. + Use internal systems to determine outcomes of claims appeals and grievances. + Review medical records and billing details ... Job Title: Specialist , Appeals & GrievancesJob Summary: Responsible...Experience: Minimum 2 years in managed care (call center, appeals , or claims ) + Experience in health… more
- Kelly Services (Glastonbury, CT)
- **Job Title:** **Bilingual** Medical Claims Processor / Medical Claims Specialist **Pay Rate:** $24.00 + /hour (Depending on exp) **Schedule:** 11:30 AM - ... Summary:** We are currently seeking a detail-oriented, organized, and compassionate **Medical Claims Processor / Medical Claims Specialist ** to join… more
- Ascension Health (Austin, TX)
- …agencies to ensure that internal and/or regulatory timelines are met. + Research claims appeals using support systems to determine appeal outcomes. + Composes ... wellness plans Retirement benefits including employer match plans Long-term & short -term disability Employee assistance programs (EAP) Parental leave & adoption… more
- Fairview Health Services (St. Paul, MN)
- …critical research and timely and accurate actions including preparing and submitting appropriate appeals or re-billing of claims to resolve coding denials to ... **Job Overview** The Inpatient Coding Denials Specialist performs appropriate efforts to ensure receipt of...records and coding guidelines to formulate coding arguments for appeals and/or coding guidance for potential re-bills. Maintains a… more
- State of Colorado (Denver, CO)
- …& Advocacy: The capacity to identify and resolve issues related to benefit applications, claims , and denials. The specialist must be able to advocate on behalf ... Benefits Specialist - Administrator II MHTLH Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5097180) Apply...of clients, including navigating appeals processes. + Interpersonal & Empathy Skills: A high… more
- State of Colorado (Denver, CO)
- Trust Policy & Recoveries Specialist Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5044040) Apply Trust Policy & Recoveries Specialist ... for overtime compensation. Department Contact Information Jessica Boyer, Talent Acquisition Specialist ~ ###@state.co.us How To Apply Please submit an online… more
- Helio Health Inc. (Syracuse, NY)
- …Maintains accurate files necessary for research and documentation. + Researches open claims and processes appeals when necessary. Follows up on patient ... support the mission of Helio Health, Inc., the Billing Specialist generates medical invoices, posts cash receipts, follows up...or concern arises. + Communicates insurance trends and unresolved appeals to the billing manager for further action. +… more
- AssistRx (Orlando, FL)
- …how to expedite patient access + Document and initiate prior authorization process and claims appeals + Report any reimbursement trends or delays in coverage to ... Day in the Life as a Bilingual Patient Access Specialist : This role works directly with healthcare providers &...(PA) for an assigned caseload and helps navigate the appeals process to access medications. + Ensure cases move… more
- AssistRx (Overland Park, KS)
- …how to expedite patient access + Document and initiate prior authorization process and claims appeals + Report any reimbursement trends or delays in coverage to ... coverage provided for a specific pharmaceutical product. The Patient Access Specialist will support the healthcare providers addressing questions regarding coding… more
- AssistRx (Phoenix, AZ)
- …how to expedite patient access + Document and initiate prior authorization process and claims appeals + Report any reimbursement trends or delays in coverage to ... provided for a specific pharmaceutical product. The Insurance Verification Specialist will support the healthcare providers addressing questions regarding coding… more
- AssistRx (Orlando, FL)
- …how to expedite patient access + Document and initiate prior authorization process and claims appeals + Report any reimbursement trends or delays in coverage to ... provided for a specific pharmaceutical product. The Insurance Verification Specialist will support the healthcare providers addressing questions regarding coding… more
- CVS Health (MN)
- …handle customer service inquiries and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication ... day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject… more
- Amergis (Columbia, MD)
- …follows up on unpaid accounts after expected payment timeframe + Corrects, resubmits claims and/or appeals claim determinations as necessary to ensure payment + ... staffing experiences to deliver the best workforce solutions. The Reimbursement Specialist I reviews branch sales for appropriate documentation, generate and bill… more
- HCA Healthcare (Brentwood, TN)
- …over 156,000 hours volunteering in our communities. As a Clinical Denials Coding Review Specialist with Parallon you can be a part of an organization that is devoted ... Program (paid time off, paid family leave, long- and short -term disability coverage and leaves of absence) + Employee...are looking for an enthusiastic Clinical Denials Coding Review Specialist to help us reach our goals. Unlock your… more
- Legacy Treatment Services (Marlton, NJ)
- Accounts Receivable Specialist Job Details Level Experienced Job Location Administration - Marlton, NJ Position Type Full Time Education Level High School Salary ... Explanation of Benefits (EOB). Review all open charges for non-payment, short payment ineligibility, inaccurate diagnoses, no authorizations, etc. Responsible for… more
- Cedars-Sinai (Los Angeles, CA)
- …daily reconciliation, processing payment transfers, reviewing and submitting claims to payors, performing account follow-up activities, updating information ... and resolve complex cases and problem accounts with minimal assistance. Submits appeals and collect monies relative to physician reimbursement. Services as a… more
