- Actalent (Boston, MA)
- …Review Clinician Job Description As a Clinical Review Clinician specializing in appeals , you will be responsible for preparing case reviews for Medical Directors ... by thoroughly researching appeals , reviewing applicable criteria, and analyzing the basis for...Plan - Pre-tax and Roth post-tax contributions available *Life Insurance (Voluntary Life & AD&D for the employee and… more
- UofL Health (Louisville, KY)
- …admissions Codes all diagnosis and procedures appropriately to obtain insurance authorizations/ appeals Explains surgical procedures/processes to patients and ... new and established patient appointments; register patients by obtaining paperwork, insurance cards, and copayments Other Functions: Maintains clean exam rooms… more
- OMNI MANOR INC (Warren, OH)
- …to maximize patient benefits. Pre-certification of admissions/ readmissions. Daily updates with insurance companies. Insurance appeals , payment appeals ... OH Description Works with the admissions team, patient/family and insurance companies to promote timely admissions utilizing appropriate precertification process… more
- UnitedHealth Group (Cypress, CA)
- …individual case review for appeals and grievances for various health plan and insurance products, which may include PPO, ASO, HMO, MAPD, and PDP. The appeals ... the US as you take on some tough challenges. Primary Responsibilities: The Appeals and Grievances Medical Director is responsible for ongoing clinical review and… more
- UnitedHealth Group (Wausau, WI)
- …experienced RNs with solid interpersonal skills to join our team. The Clinical Appeals RN will be responsible for reviewing appeals and provider inquiries ... prescribed by the plan benefits. As a post-service clinical appeals RN, you will be putting your detective skills...this requirement) Preferred Qualifications: BSN degree or higher Health Insurance industry experience Knowledge of ICD - 10 /… more
- St. Luke's University Health Network (Allentown, PA)
- …a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all ... for the purpose of appealing proposed DRG and coding changes by insurance providers or their respective auditors JOB DUTIES AND RESPONSIBILITIES: Conduct… more
- Stony Brook University (Stony Brook, NY)
- …services. Perform minor joint procedures. Work with clinic staff together for insurance appeals and pre-authorizations as necessary. Coordination with clinic ... staff of patient care for both outpatients and inpatients related to rheumatologic care, including national and international referrals. Perform consents, including for genetic testing. Cover physicians during their absence as necessary. Perform other duties… more
- Dane Street, LLC (Mclean, VA)
- …Independent Medical Exams (IME), you will utilize clinical expertise and reviews insurance appeals , and prospective and retrospective claims. The Physician ... Reviewer will provide an interpretation of the medical necessity of services provided by other healthcare professionals in compliance with client specific policies, nationally recognized evidence-based guidelines, and standards of care. Requirements Reviews… more
- Experity (Machesney Park, IL)
- …find the root cause and take necessary actions to resolve Submit corrected insurance claims and/or appeals , as necessary, with appropriate documentation based on ... between $17 and $19.50 dependent upon experience Responsibilities: Manage outstanding insurance AR for assigned clients along with providing trending information to… more
- Regal Medical Group, Inc. (Northridge, CA)
- …Employer-paid comprehensive medical, pharmacy, and dental for employees Vision insurance Zero co-payments for employed physician office visits Flexible Spending ... Account (FSA) Employer-Paid Life Insurance Employee Assistance Program (EAP) Behavioral Health Services Savings and Retirement: 401k Retirement Savings Plan Income… more
- Outreach Community Health Centers, Inc (Milwaukee, WI)
- …as required. Perform additional duties as assigned. Experience in filing claim appeals with insurance companies to ensure maximum entitled reimbursement. ... Experience with Medicare and Medicaid claims is preferred. Familiarity with insurance processes, managed care, PPOs, FQHC billing, and Milwaukee County systems… more
- City Of Concordia (Concordia, KS)
- …liaison for the Planning Commission and the Board of Zoning Appeals preparing staff reports, providing required/requested information, and providing resultant ... Trades meetings required. Attendance at Planning Commission and Board of Zoning Appeals meetings may be required. JOB QUALIFICATIONS Ability to work independently… more
- Riccobene Associates Family Dentistry (Goldsboro, NC)
- …platform As requested, assist Revenue Cycle Management (RCM) as needed with insurance denial appeals , credentialing, coding, or other billing issues identified ... an accredited dental school Valid state dental license and malpractice insurance Valid DEA license Current CPR Certification Essential Requirements Strong… more
- Columbia-Greene Community College Foundation (Hudson, NY)
- …outcomes of giving to donors at all levels. Coordinate mass annual appeals , communications with constituents, and website updates, in collaboration with the ... College offers a comprehensive benefits package that includes medical and dental insurance , short- and long-term disability, generous vacation, and sick leave, paid… more
- DNA Comprehensive Therapy Services (Fort Myers, FL)
- …for delay in payment. Answer patient questions regarding their balance. Filing appeals with insurance companies Posting appropriate non-payment from insurance ... The Medical Collector communicates with insurance companies and governmental entities to ensure maximum...a timely manner. Review and handle all correspondence from insurance companies and patients. ESSENTIAL DUTIES AND RESPONSIBILITIES: Works… more
- Torrance Memorial Medical Center (Torrance, CA)
- …Rep is responsible for reviewing denied claims and carrying out the appeals process. Works to maintain third-party relationships, including responding to inquiries, ... Knowledgeable of state/federal laws that relate to contracts and to the appeals process. Assists the Denials Management Senior Analyst with reports and provides… more
- On Point Staffing Group (Little Falls, NJ)
- Join our dynamic team as a Medical Insurance Accounts Receivable Specialist, where your expertise in medical billing will contribute to our financial success. This ... on managing Accounts Receivable to ensure prompt and accurate payment from insurance providers. Key Responsibilities: Manage and process medical insurance claims… more
- BlueCross BlueShield of South Carolina (Columbia, SC)
- …as needed to resolve inquiries. Reviews and adjudicates claims and/or non-medical appeals . Determines whether to return, deny or pay claims following organizational ... in the South Carolina community. We are the largest insurance company in South Carolina and much more. We...responsibilities include review and adjudication of claims and/or non-medical appeals , determining whether to return, deny or pay claims… more
- Woundlocal (Austin, TX)
- …to the medical team, ensure timely submission to payers, review claim denials, submit appeals , and bill secondary insurance . All claims are made for advanced ... professional with extensive experience in Medicare billing and commercial and federal insurance benefits verification. Must be able to perform, train, and oversee… more
- UF Health (Jacksonville, FL)
- …claims submissions. Registers patients and completes necessary documentation including insurance verification and benefits determination. Research charges to submit ... by physicians and non-physician providers maintaining timely claims submissions and timely Appeals process as defined by individual payors. Review and facilitate the… more
