- Rady Children's Hospital San Diego (San Diego, CA)
- …claim submission. This position is responsible for pulling medical records to submit with claims and appeals as required by payors. Responsible to validate and ... incumbent completes daily processing of claim edits or rejected claims processed through the billing system and from electronic...accurately complete the claims identified with potential new payor plan coverage added… 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)
- …of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding ... 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 ... **Job Duties** + Review and analyze denied or underpaid claims to determine appeal opportunities. + Prepare and submit...staff and coding teams to obtain necessary documentation for appeals + Track and monitor appeal status, maintaining detailed… more
- Texas Veterans Commission (Borger, TX)
- …rulings, and state law in the adjudication process. . Prepares and files claims and appeals with supporting evidence for successful adjudication. . Advises ... Financial Operations* **Organization:** **TEXAS VETERANS COMMISSION* **Title:** *TVC - Claims Benefit Advisor (Veterans Services Representative I)* **Location:**… more
- Guidehouse (El Segundo, CA)
- …Required** **:** None **What You Will Do** **:** The **Insurance Patient Account Representative ** **(Hospital Claims )** is an extension of a client's business ... and three days from home._** **Essential Job Functions** + Account Review + Appeals & Denials + Medicare/Medicaid + Insurance Follow-up + Customer Service + Billing… more
- Kelly Services (Myrtle Beach, SC)
- …Great opportunities are right here in your backyard. Kelly(R) is looking for a Claims Customer Service Representative to work at a premier organization in Myrtle ... - $23 Why you should apply to be a Claims Customer Service Representative : + Competitive pay...written, web, or walk-in inquiries. + Reviewing and adjudicating claims and/or non-medical appeals , determining whether to… more
- Mendocino County Sheriff's Office (Ukiah, CA)
- …Must obtain accreditation by the California Department of Veterans Affairs as a Claims Representative in accordance with Title 38 Code of Federal Regulations ... such as military, medical, and legal records. + Prepares, submits, and monitors claims and appeals through appropriate federal, state, and local channels,… more
- Insight Global (Nottingham, MD)
- …diploma or equivalent * Outpatient hospital billing experience * Experience with facility claims follow-up & appeals handling o Experience with UB04 forms o ... is looking for an Outpatient Facility Claim Follow Up Representative to support a large hospital system in the...corrective actions with payers. This team focuses on facility claims only, and this role is focused only on… more
- TEKsystems (Farmington, CT)
- Insurance Follow‑Up Representative (Hybrid) Shift: 7:30 am - 4:00 pm Employment Type: Full-Time Schedule: Monday - Friday Pay Rate: $25-27/HR Hybrid Schedule (After ... A leading academic health system is seeking an experienced Insurance Follow‑Up Representative to support its hospital billing operations. This role focuses on… more
- Guidehouse (San Marcos, CA)
- …San Marcos office and three days from home._** **Essential Job Functions** + Hospital Claims + Account Review + Appeals & Denials + Medicare/Medicaid + Insurance ... **Job Family** **:** Patient Account Representative **Travel Required** **:** None **Clearance Required** **:**...+ 1+ year's medical provider experience working with UB04, appeals & denials. + Hospital or EOB claims… more
- Rochester Regional Health (Rochester, NY)
- JOB TITLE: Collections and Denials Management Representative LOCATION: SLH DEPARTMENT: Patient Financial Services Hours: 37.5 SCHEDULE: Monday-Friday 8AM-4PM ... Billing and Denials Specialist is responsible for managing the billing process, submitting claims to insurance companies, following up on unpaid or denied claims… more
- SSM Health (Madison, WI)
- …and payment rules. Bills claims appropriately. + Follows up on denied claims by performing appeals and denial recovery procedures. Works denied claim lines ... the following: processing insurance payments, following up on denied claims , and resolving credit balances. May work in multiple...and no response claims to resolve outstanding accounts. + Analyzes credit balances… more
- Owens & Minor (Springfield, IL)
- … representative follows-up with insurance companies to resolve unpaid claims . **ESSENTIAL DUTIES AND RESPONSIBILITIES** + Researches any overdue account balance ... insurance carriers or customers on delinquent payments. + Reviews unpaid and underpaid claims . Resubmits or appeals as necessary. + Verifies payment information… more
- TEKsystems (Chicago, IL)
- Patient Account Representative Location: Must reside in CST Schedule: 8:00 AM - 4:30 PM CST Overview The Patient Account Representative is responsible for ... accounts using hospital systems and online resources. + Follow up on unpaid claims with insurance companies and patients via phone, email, or online. + Review… 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 ... role related to health insurance, health care operations, insurance claims and billing, collections, or a field related to...the official appeal form signed by you or your representative . This form must be completed and delivered to… 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
- WellSpan Health (Lewisburg, PA)
- …Assists in the completion of submitting electronic and/or manual insurance claims , resolves claim edits, performs insurance account follow-up, researches claim ... denials for resolution and submits disputes and appeals when necessary. Represents the System in a professional...or manual processes and facilitates special billing for split claims , ancillary charges, interim bills, etc.- Resolves Claim edits… more
- WellSpan Health (York, PA)
- …Assists in the completion of submitting electronic and/or manual insurance claims , resolves claim edits, performs insurance account follow-up, researches claim ... denials for resolution and submits disputes and appeals when necessary. Represents the System in a professional...or manual processes and facilitates special billing for split claims , ancillary charges, interim bills, etc.- Resolves Claim edits… more
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