- Rady Children's Hospital San Diego (San Diego, CA)
- …position is responsible for pulling medical records to submit with claims and appeals as required by payors. Responsible to validate and accurately complete the ... claims identified with potential new payor plan coverage added to the patient's account. Assists with other related duties as assigned. SKILLS REQUIRED: - Excellent verbal communication and active listening. Effective verbal communication is one of the most… more
- Northwestern Mutual (Franklin, WI)
- …and communication with field and customer to include responding to case appeals /inquiries and assists with placing business. Provides guidance and assistance to the ... for case management Cross-functional leadership May serve as underwriting representative for improvement in product process w/collaboration w/functional partners.… more
- 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 team on ... health insurance operations by managing documentation, coordinating with providers, and ensuring appeals and grievances are processed accurately and on time. This is… more
- Robert Half Office Team (Minneapolis, MN)
- …you looking for a rewarding remote role in healthcare administration? This Clinical Appeals Representative position offers the opportunity to make a meaningful ... impact while working from the comfort of your home. As a Clinical Appeals Representative , you will play a key role in managing the intake and processing of… more
- Point32Health (FL)
- …(https://www.point32health.org/) . **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Appeals and Grievance Analyst ... the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual works… more
- Point32Health (Canton, MA)
- …(https://www.point32health.org/) . **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Member Appeals and Grievance ... the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual works… 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 ... determination made by the government or commercial payors, or their auditor representative . + Facilitate clinical chart reviews to assist with supporting assigned… more
- Ochsner Health (New Orleans, LA)
- …make a difference at Ochsner Health and discover your future today!** The Appeals Specialist is responsible for managing and resolving insurance claim denials and ... staff and coding teams to obtain necessary documentation for appeals + Track and monitor appeal status, maintaining detailed...and Environmental Demands** The physical demands described here are representative of those that must be met by an… more
- Northwell Health (Melville, NY)
- …medical necessity for assigned case. + Collaborates with physician advisor, payor representative and site case managers to facilitate appropriate level of care ... current state, federal, and third-party payer regulations. Ensures clinical reviews and appeals are up to date and accurately reflect patient's severity of illness… more
- HANAC, Inc. (Astoria, NY)
- …integral part of a team with the immigration attorney, Board of Immigration Appeals (BIA) accredited representative , and support staff. The Immigration Paralegal ... will assist the staff attorney and the Program Director in providing legal services, education, and outreach, including coordination of community events, and working under attorney supervision to assist clients on Immigration law matters. The Paralegal will… more
- Mendocino County Sheriff's Office (Ukiah, CA)
- Veteran's Services Representative Print (https://www.governmentjobs.com/careers/mendocinoca/jobs/newprint/5169641) Apply Veteran's Services Representative ... full-time, and part-time positions, should they occur. The Veterans Services Representative provides essential support and assistance to veterans and their… more
- Whidbey General Hospital (Oak Harbor, WA)
- JOB SUMMARY The Patient Financial Services Representative supports the mission of providing quality healthcare to the patients of WhidbeyHealth by performing a ... support the financial health and well-being of the organization. The PFS Representative may be responsible for coordinating patient referrals and subsequent follow… more
- CVS Health (Woonsocket, RI)
- …Fluency in English and Spanish is required.** **Position Summary** Customer Service Representative is the face of Aetna and impacts members' service experience by ... referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system. + Educates providers on our… more
- Guidehouse (San Marcos, CA)
- **Job Family** **:** Patient Account Representative **Travel Required** **:** None **Clearance Required** **:** None **What You Will Do** **:** The **Insurance ... Patient Account Representative - Hospital A/R Emphasis** is an extension of...Job Functions** + Hospital Claims + Account Review + Appeals & Denials + Medicare/Medicaid + Insurance Follow-up +… more
- State of Colorado (Denver, CO)
- Health Care Representative Center Call Agent Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5156102) Apply Health Care Representative ... submitted by you, using the official appeal form signed by you or your representative . This form must be completed and delivered to the State Personnel Board by… more
- Corewell Health (Grand Rapids, MI)
- Practice and Culture This Patient Service Representative position is responsible for creating a welcoming and efficient experience for patients. This role involves ... will be 8 am - 2 pm. Job Summary As a Patient Services Representative with Corewell Health, you'll play a vital role in delivering top-notch healthcare service… more
- Guidehouse (Birmingham, AL)
- **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,...taking necessary actions to obtain account resolution. + Submits appeals , as appropriate, for all non-clinical denials + Monitors… 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 ... securing signatures on the form from the patient or their legal representative , and answering questions regarding the appeal process + Distributes the Medicare… more
- Texas Veterans Commission (Borger, TX)
- …state law in the adjudication process. . Prepares and files claims and appeals with supporting evidence for successful adjudication. . Advises and assists veterans ... any reasonable accommodation for the interview process, please inform the hiring representative who calls to schedule your interview.** **This position has been… more
- Insight Global (Nottingham, MD)
- …Description Insight Global is looking for an Outpatient Facility Claim Follow Up Representative to support a large hospital system in the Maryland/DC area. This ... contract interpretation issues-not clinical denials or patient balances. The representative ensures accurate reimbursement by analyzing Explanation of Benefits… more
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