- Equitable (Charlotte, NC)
- Appeals Specialist , Disability Claims ( 25000066 ) **Primary Location** : UNITED STATES-NC-Charlotte **Other Locations** : UNITED STATES- Remote , UNITED ... your potential? Equitable is seeking an influential and dynamic Appeals Specialist to join our Disability and...Equitable provides a full range of benefits. This includes medical , dental, vision, a 401(k) plan, and paid time… more
- Healthfirst (UT)
- …+ Work within a framework that measures productivity and quality for each Specialist against expectations + Prepare cases for Medical Director Review ensuring ... This position is 100% Remote . We are hiring for the following schedules...of clinical cases, such as: Pre-existing Conditions, Prior Approval, Medical Necessity, Pre-certification, Continued Stay, Reduction, Termination, and Suspension… more
- State of Colorado (Denver, CO)
- ECMC Enforcement Advisor (Compliance Specialist IV) - Remote /Hybrid Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4887965) Apply ECMC ... Enforcement Advisor (Compliance Specialist IV) - Remote /Hybrid Salary $68,100.00 -...addition to offering rewarding, meaningful work, we offer: + Medical , Vision and Dental plans + Strong, flexible retirement… more
- Trinity Health (Albany, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** **Revenue Integrity Charge Specialist - Medical ** **Associates - Remote - FT** If you ... we care for more people in more places. This position is full time remote . **Position Highlights:** + **Quality of Life:** Where career opportunities and quality of… more
- St. Luke's University Health Network (Allentown, PA)
- …, case resolution, and impact on revenue and trending. + Coordinates RAC appeals for complex case reviews for medical necessity, including determining if ... ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party denials for... reviews inpatient CMS and third party denials for medical necessity and tracks outcomes regarding appeal process. Assists… more
- Robert Half Accountemps (Spokane, WA)
- …Receivable (A/R) Specialists to support a long-term collections project. This role is 100% remote , but candidates must be able to work standard business hours in the ... of outstanding A/R balances + Manage insurance claim follow-up, appeals , and denials resolution + Review and reconcile patient...management skills + Ability to work independently in a remote setting + Must be able to work during… more
- Trinity Health (Syracuse, NY)
- **Employment Type:** Full time **Shift:** **Description:** Certified Coder Fully remote . May include every 5th weekend rotation **POSITION PURPOSE** Responsible for ... are in alignment with in AMA and Medicare coding guidelines. Ensures medical documentation and coding compliance with Federal, State and Private payer regulations.… more
- Omaha Children's Hospital (Omaha, NE)
- **Schedule: FT, Mon - Fri, Days, Flexible Schedule, Remote after training** At Children's Nebraska, our mission is to improve the life of every child through ... of all insurance and government payor payments, rebills underpayments, appeals denials and turns them into payments, and ensures...formats. + Completes all requests and follow ups with medical records, pharmacy, etc. in order to ensure payments… more
- PeaceHealth (Vancouver, WA)
- **Description** **PeaceHealth is seeking a Referral/Pre-Auth Specialist - Remote (OR, WA, AK) for a Full Time, 0.80 FTE, Day position.** The salary range for ... are met and referral support documentation is filed in patient's medical record. + Efficiently manages correspondence with patients, physicians, specialists, and… more
- Avera (Wagner, SD)
- …issues and also help with patient concerns. Will assist in denial management and appeals . Day shift hours, Monday through Friday. ** Remote work is NOT ... **Position Highlights** **Starting rate of pay is $26.50 per hour.** The Billing Specialist will be responsible for the daily billing operations for designated areas… more
- ProMedica Health System (Toledo, OH)
- …documentation and coding practices, including regulatory changes or updates. Reviews medical record documentation and claims data to ensure compliance with CMS ... or other payer requests; performs appropriate follow up including appeals and corrective actions with departments and staff. 8....other duties as assigned. This position can be worked remote . Must live in 150 mile or less radius… more
- Trinity Health (Syracuse, NY)
- …are in alignment with in AMA and Medicare coding guidelines. Ensures medical documentation and coding compliance with Federal, State and Private payer ... Service (PBS) centers; including analysis of clinical documentation, assist in appeals as needed, root cause analysis and tracking as needed.Educates clinical… more
- Johns Hopkins University (Baltimore, MD)
- …and/or relating to high-cost procedures. Will incorporate research findings on medical policy into appeals documentation. Communicates with payers to ... We are seeking an **_AR Revenue Cycle Specialist III_** who will be responsible for the...facilitate prompt payment of claims. Communicates with providers regarding appeals and medical policy denials and provides… more
- CareFirst (Baltimore, MD)
- …and quality monitoring organizations (NCQA). + Builds and maintains high performance complex medical networks to support the needs of the market and our clients. + ... hospitalist, diabetes education, reduction of authorizations, reduction of claims appeals , etc.). Participate in internal and external committees and workgroups,… more
- Colorado State University (Fort Collins, CO)
- …assist in other billing roles as needed. At this time, the Insurance Payment Poster Specialist works a hybrid onsite/ remote schedule from 8:00 AM - 5:00 PM, ... medical insurance plan. + Work with the other Medical Billing &payment Posting Specialist to determine...provided by the insurance company for necessary claims denial appeals . + Evaluate student insurance policy eligibility by utilizing… more
- Spectrum Billing Solutions (Skokie, IL)
- …Account Specialist | Reimbursement Specialist | Billing/Revenue Cycle Management Specialist | Medical Billing Specialist | Collections Associate | ... We are looking to add a passionate and skilled Revenue Cycle AR Collections Specialist to our growing team. The ideal candidate will use their skills and knowledge… more
- Independent Health (Buffalo, NY)
- …reconsideration clinical appeals to include review of records, consultation with Medical Director, response to facilities as well as coordination of all aspects ... fosters growth, innovation and collaboration. **Overview** The Clinical & Coding Specialist -Senior will be responsible for reviewing coding and clinical decisions on… more
- State of Colorado (CO)
- …Mental Health Transitional Living (MHTL) Homes Benefits Specialist Work Lead Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4950651) Apply ... Administrator III Mental Health Transitional Living (MHTL) Homes Benefits Specialist Work Lead Salary $57,708.00 - $75,024.00 Annually Location Statewide, CO Job… more
- LA Care Health Plan (Los Angeles, CA)
- …Audit Readiness Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... achieve that purpose. Job Summary The Customer Solution Center (CSC) Audit Readiness Specialist II is responsible for the execution, oversight, and monitoring of the… more
- AssistRx (Phoenix, AZ)
- …Benefits Verification Specialist : + In-depth understanding and experience with Major Medical & Pharmacy Benefit Coverage + 2 to 3 years of benefit investigation ... A Day in the Life as a Benefits Verification 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