- Robert Half Accountemps (Eden Prairie, MN)
- Description Clinical Appeals Representative (Contract - Fully Remote) We're seeking a detail-oriented Clinical Appeals Representative to join our ... health insurance operations by managing documentation, coordinating with providers, and ensuring appeals and grievances are processed accurately and on time. This is… more
- Adecco US, Inc. (Ontario, CA)
- Adecco Medical & Science is hiring a REMOTE Clinical Appeals Representative for a healthcare organization based in Ontario, CA! This is a 100% remote ... opportunity with occasional in-office visits to process mail at the Ontario location. Please read the details below and apply with a current resume for consideration. Position Details: * Type: Contract position * Schedule: Monday - Friday, 8:00 AM - 4:30 PM… more
- Humana (Oklahoma City, OK)
- …with clinical and other Humana parties. The Grievances & Appeals Representative 3 performs advanced administrative/operational/customer support duties that ... and help us put health first** The Grievances & Appeals Representative 3 manages client denials and...and concerns by conducting a comprehensive analytic review of clinical documentation to determine if an a grievance, appeal… more
- St. Luke's University Health Network (Allentown, PA)
- …regardless of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data ... coding determination made by the government or commercial payors, or their auditor representative . + Facilitate clinical chart reviews to assist with supporting… more
- Guidehouse (Birmingham, AL)
- …Insurance Companies to resolve claim denials and account balances. + Performing Non- Clinical Appeals . + Assisting Supervisor/Manager as needed with various ... **Job Family** **:** Patient Account Representative **Travel Required** **:** None **Clearance Required** **:**...+ 0-2 years medical billing experience working with UB04, appeals & denials. **What Would Be Nice to Have**… more
- Huron Consulting Group (Boston, MA)
- …Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new ... partnerships, clinical services and technology is not enough to create...employee engagement across the enterprise. + The Pre-Service Financial Representative supports the Revenue Cycle by financially clearing urgent… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Case Management Representative position is responsible for providing clerical assistance and data management support to the case management ... and routes issues to appropriate individuals, assists in resolution of non- clinical issues as needed + Facilitates and arranges acquisition of post-acute… more
- Reno Orthopedic Center (Reno, NV)
- Reno Orthopedic Center wants you to join the team as a Patient Billing Representative ! We are seeking an enthusiastic and dedicated team member to communicate with ... part of who we are; we strive for constant improvement in everything from clinical innovation to personal development. . We value kindnessas a core strength - it's… more
- Guidehouse (Birmingham, AL)
- …+ Works all denials taking necessary actions to obtain account resolution. + Submits appeals , as appropriate, for all non- clinical denials + Monitors all denials ... **Job Family** **:** Patient Account Representative **Travel Required** **:** None **Clearance Required** **:**...None **What You Will Do** **:** The Patient Account Representative (PAR) is expected to perform specific billing processes,… more
- Veterans Affairs, Veterans Health Administration (Oklahoma City, OK)
- …laws, regulations, policies and procedures governing eligibility, benefits, care, access, services, clinical appeals , and privacy and skill in applying this ... laws, regulations, policies and procedures governing eligibility, benefits, care, access, services, clinical appeals , and privacy and skill in applying this… more
- Rochester Regional Health (Rochester, NY)
- Job Title: Business Office Representative Department: Location: Hours Per Week: Schedule: Sign-On Bonus: SUMMARY: Ensure full reimbursement is received by RRH for ... clinical services rendered including professional, long-term/home care and hospital...phone calls to the payer. Submit corrected claims and appeals . + Process account adjustments and refunds as needed… more
- Surgery Care Affiliates (Boise, ID)
- …do it. Each decision we make is rooted in seven core values: + Clinical quality + Integrity + Service excellence + Teamwork + Accountability + Continuous improvement ... change. If you join our team, they will. Responsibilities The Patient Account Representative will be responsible for thorough and timely patient account follow up… more
- BrightSpring Health Services (Bowling Green, KY)
- …Health Plan was formerly Signature Advantage* We are seeking a Sales Account Representative /Executive for our Abilis Health Plan who will work with senior care ... unresolved issues to the next level including grievance and appeals . + Actively market plan to new senior care...and innovative services allow us to meet each member's clinical needs and provide preventive, coordinated, and quality healthcare.… more
- Highmark Health (Buffalo, NY)
- …timely receipt, review and assignment of all incoming physician reviewer referrals and appeals to ensure that NCQA, URAC, CMS, DOH, DOL and state specific regulatory ... for reporting purposes (20%) 3. Responsible to efficiently coordinate the clinical review process with contracted external review companies in accordance with… more
- State of Colorado (Denver, CO)
- …meetings, group consultation, and regional meetings as required. Serves as clinical representative to various DYS and/or community agency/stakeholder task ... Behavioral Health Services Manager - Clinical Team Leader for Behavioral Health & Medical...if your application is eliminated. You will find the appeals process, the official appeal form, and how to… more
- Northwell Health (New Hyde Park, NY)
- …billing/clerical staff regarding billing and office/clerical functions. + Carries out clinical documentation requests to business office to ensure timely appeals ... . + Implements policies and procedures to facilitate billing and maximize case collections. + Implements improvements for financial management of each billing area. + Performs related duties as required. All responsibilities noted here are considered essential… more
- Northwell Health (Melville, NY)
- …There are a wide range of career opportunities available from medical coders and appeals to auditors and clinical documentation. From our customer service team ... members who are handling patient registration and patient financial counseling in our hospitals, to those working in non-patient-facing areas such as insurance verification or health information management, they're working together to improve the experience of… more
- Northwell Health (Melville, NY)
- …Guides billing/clerical staff regarding billing and office/clerical functions. + Coordinates clinical documentation requests to business office to ensure timely ... appeals . + Develops and implements policies and procedures to facilitate billing and maximize case collections. + Reviews and recommends improvements for financial… more
- University of Rochester (Rochester, NY)
- …closure and obtain maximum revenue collection. Researches, corrects, resubmits claims, submits appeals and takes timely and routine action to resolve unpaid claims. ... hospital departments or department representatives. + Researches and responds to clinical department inquiries on complex, high dollar, and specialized accounts and… more
- State of Colorado (Pueblo, CO)
- SOCIAL WORK/COUNSELOR III- Clinical Work Lead COT Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5042105) Apply SOCIAL WORK/COUNSELOR III- ... Clinical Work Lead COT Salary $81,000.00 - $113,400.00 Annually...if your application is eliminated. You will find the appeals process, the official appeal form, and how to… more