- A-Line Staffing Solutions (Sacramento, CA)
- …verbal and written communication Skills Strong written and critical Skills Preferred Requirements: Previous Grievance and Appeals experience preferred ... Medical management, utilization management or experience running Doctors office preferred Grievance and Appeals Coordinator, grievance and appeals ,… more
- Cambia Health Solutions, Inc (Tacoma, WA)
- Appeals Specialist IRemote within WA, ID, OR, and UTPrimary Job Purpose:Responsible for all activities associated with requests for Provider Billing Disputes and ... Appeals . Includes analysis, preparation, evaluation of prior determinations, coordination of clinical review if needed, decision making, notification, and completion.… more
- Blanchard Valley Health System (Findlay, OH)
- …of productivity to effectively reduce days in A/R. Develops and writes appeals for denials associated with the payment of claims within the department/division. ... Maintains appropriate timeliness of appeals for denials. Identifies other means and resources to complete tasks, as applicable and appropriate. Helps create and… more
- A-Line Staffing Solutions (Cleveland, OH)
- …least 45 wpm, and have skills with MS Word, Outlook, & Excel Preferred Experience: 1-2+ years of utilization review experience. Case Management certification (CCM) ... Nurse, Travel RN, Home Health Nurse, Home Health RN, Grievance and Appeals , Denials, MCO, CCM, InterQual, ICD-10, URAC, CMS, Medicare, Medicaid, Case Management,… more
- Penske Truck Leasing Co., LP (Reading, PA)
- …or manager with operating tax compliance processes including rendition/return filing, appeals and abatements and refund/bill entry. * Be able to understand ... or manager with operating tax compliance processes including rendition/return filing, appeals and abatements, bill entry for operating tax * Analyze processes,… more
- Abbtech Professional Resources (Washington, DC)
- …of criminal litigation, including pretrial discovery, motions, hearings, trials, and appeals . * Reviews and analyzes documents, transcripts, files, and other ... is being conducted in Relativity, so Relativity experience is preferred , but experience in electronic document review in some...MS Teams and for phone calls; this is the preferred methods of communication. In addition, due to the… more
- Cambia Health Solutions, Inc (Renton, WA)
- …The position develops, maintains and publishes reimbursement policy. Preferred Key Experience:Clinical knowledge (Understands clinical reviews)Understanding of ... claims, billing and codingFacets/claims systems in appeals , SIUClaims processing, claims configuration rolesUnderstanding of Medical and reimbursement policiesCPC… more
- Cambia Health Solutions, Inc (Boise, ID)
- …medical exception requests, prior authorization requests, reconsiderations, and appeals . Prepares reconsideration requests for Clinical Pharmacy Consultant review ... pricing calculations.Ability to type 30 words per minute, 60 wpm preferred .Demonstrated ability to operate a variety of standard business machines including… more
- Jazz Pharmaceuticals (New York, NY)
- …and ensure providers understand payer prior authorization requirements, appeals process, clinical criteria, and appropriate coding information.Demonstrate deep ... working with billing and medical claims personnel in healthcare settings preferred .Strong oral, written, and group communication skills.Ability to lead without… more
- George Washington University (Washington, DC)
- …software. Logs, tracks, and segments donors and donations for future appeals . Continuously seeks opportunities for improvement in financial practices and internal ... of the position. Additional Required Licenses/Certifications/Posting Specific Minimum Qualifications: Preferred Qualifications: Experience in accounting, financial management or grant… more
- Creative Financial Staffing (Brewster, NY)
- …through cost date analysis Participating in the development and preparation of rate appeals , under direction of CFO. What we are looking for: Bachelor's degree, ... preferably in accounting or finance Master's degree preferred Proficiency in general ledger systems and subsystems 3+ years of experience in accounting and finance,… more
- ConsultNet (Scottsdale, AZ)
- …in resolving tax-related disputes and participate in negotiations, settlements, and appeals , if required. Oversee Year End Payroll Processes with vendor Required ... equivalent combination of education and experience.Bonus Skills: UKG Payroll Experience Preferred . FPC/CPP certification preferred Welcome to ConsultNet and the… more
- A-Line Staffing Solutions (Orlando, FL)
- …term care services Assist member with filing and resolving complaints and appeals Bilingual Case Manager Requirements Bachelor's degree or Registered Nurse License ... experience. Home health, discharge planning, or long term care experience preferred . Licenses/Certifications: Valid driver's license If you think this Bilingual Case… more
- RestoraCare Staffing (Houston, TX)
- …of an accredited school of professional nursing required; Bachelors of Nursing preferred , or graduate of an accredited Master of Social Work program. ... as a Master Social Worker (LMSW) in the state of Texas required, LCSW preferred . Certification in Case Management required within two (2) years of hire into the… more
- Creative Financial Staffing (New York, NY)
- …clients' tax positions. Assist in representing clients in tax audits and appeals , as needed. Collaborate with other departments to provide integrated tax solutions ... Accountant: Bachelor's degree in Accounting, Finance, or related field; CPA certification preferred . 2+ years of experience in tax accounting, preferably in a… more
- Valmont Industries, Inc. (Miami Shores, FL)
- …respond to agency audit request, complaint investigation/resolution measures, unemployment claims & appeals (OSHA, EEC, DOL, OFCCP, DFEH, etc.)Must keep up to date ... Qualifications of Every Candidate (Education, Experience, Knowledge, Skills and Abilities): Preferred Bachelors with 3+ years relevant experience or Associates Degree… more
- Creative Financial Staffing (Chicago, IL)
- …payers for reimbursement. Post payments accurately and reconcile accounts. Conduct appeals , root cause analysis, and billing tasks efficiently. Assist with other ... revenue cycle-related duties as needed. Preferred qualifications for the Revenue Cycle Specialist: Billing or Coding Certification. Outpatient billing experience is… more
- Compass Health Network (Sullivan, 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" ... and values diversityHigh School/GED degree requiredAssociate/Bachelor's degree in nursing preferred LICENSURE/CERTIFICATION: GPN, LPN, GN or RN that must pass… more
- Staffing Now (Tampa, FL)
- …limits; otherwise forward to Claims Manager * Potentially process refunds appeals , disputes and adjustments (when applicable); * Identify process improvement ... perform basic to intermediate mathematical computation routines * Medical terminology strongly preferred * Understanding of ICD-9 & ICD-10 * Basic MS office computer… more
- Elevance Health (Cincinnati, OH)
- …and Experiences:** + Prior experience working coverage determination or prior experience with appeals preferred . + Experience creating reports preferred . + ... **Grievance/ Appeals Analyst Lead** **Must be located within 50...experience preferred . + Experience managing volume/turnaround times preferred . + Associate's or BA/BS degree preferred .… more
