• Clinical Denials & Appeals

    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
    Northwell Health (12/06/25)
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  • Collections & Denials Management…

    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 ... SUMMARY: A Medical Billing and Denials Specialist is responsible for managing the billing process,...accurate account resolution in line with payer requirements. + Appeals & Reimbursement Review: Conduct detailed reviews of denied… more
    Rochester Regional Health (11/21/25)
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  • PFS Insurance Follow-Up Rep Ambulatory…

    Banner Health (AK)
    …the best place to work and receive care. **The PFS Insurance Follow-Up Representative (Ambulatory Denials )** is responsible for following up with assigned payer ... for various denials , such as no authorization, eligibility denials ,...payments, contract discrepancies, incorrect financial classes, internal/external errors. Makes appeals and corrections as necessary. 4. Builds strong working… more
    Banner Health (12/17/25)
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  • Senior Financial Analyst - Specialized…

    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 ... + Experience in healthcare or revenue cycle - specifically insurance claim denials . + Strong analytical and organizational skills. + Excellent communication and… more
    Ochsner Health (10/11/25)
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  • RN Clinical Review Appeals Specialist

    St. Luke's University Health Network (Allentown, PA)
    …needed for workflow or identification of trends. Assists in preparing reports regarding denials to include volumes, number of appeals , case resolution, and ... 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… more
    St. Luke's University Health Network (10/28/25)
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  • Remote BCBS Facility Claim Follow-Up…

    Insight Global (Nottingham, MD)
    …resolving underpayments, denials , and contract interpretation issues-not clinical denials or patient balances. The representative ensures accurate ... 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… more
    Insight Global (12/16/25)
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  • Third Party Patient Account Representative

    Guidehouse (Birmingham, AL)
    …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
    Guidehouse (11/13/25)
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  • Patient Account Representative - Hospital…

    Guidehouse (San Marcos, CA)
    …from home._** **Essential Job Functions** + Hospital Claims + Account Review + Appeals & Denials + Medicare/Medicaid + Insurance Follow-up + Customer Service ... **Job Family** **:** Patient Account Representative **Travel Required** **:** None **Clearance Required** **:**...+ 1+ year's medical provider experience working with UB04, appeals & denials . + Hospital or EOB… more
    Guidehouse (11/16/25)
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  • Insurance Follow Up Representative

    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
    TEKsystems (12/11/25)
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  • Case Management Representative

    Houston Methodist (Houston, TX)
    …on insurance/managed care benefits + Supports and assists with concurrent insurance denials and appeals process, transmission of utilization reviews to insurance ... At Houston Methodist, the Case Management Representative position is responsible for providing clerical assistance and data management support to the case management… more
    Houston Methodist (11/08/25)
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  • Insurance Follow-up Representative II

    Novant Health (Charlotte, NC)
    What We Offer Insurance Follow-Up Representative II The Insurance Follow-Up Representative II is responsible for managing patient (medical) accounts receivable ... queues (including Cancer, Psychiatry, and Neurosciences), analyze denial trends, complete appeals , and address takebacks. + Identify and report preventable … more
    Novant Health (12/15/25)
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  • Patient Account Representative - Treasure…

    Surgery Care Affiliates (Boise, ID)
    …change. If you join our team, they will. Responsibilities The Patient Account Representative will be responsible for thorough and timely patient account follow up ... Effectively and independently handles second level reimbursement issues, contracted and non-contracted denials for serviced before and after procedures. + Works all … more
    Surgery Care Affiliates (11/13/25)
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  • Patient Account Representative

    Robert Half Accountemps (Palo Alto, CA)
    …with the payers either by phone or via websites. Works payer denials based on claim process adjudication; Review accounts for possible underpayments; research ... contracts, guidelines and resolve payment with payer. Perform appeals with payer. Performs bad debt request transfers as applicable. Performs or requests adjustment… more
    Robert Half Accountemps (12/12/25)
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  • Patient Financial Services Representative

    Banner Health (WY)
    …May be assigned to process payments, adjustments, claims, correspondence, refunds, denials , financial/charity applications, and/or payment plans in an accurate and ... assigned, reconciles, balances and pursues account balances and payments, and/or denials , working with payor remits, facility contracts, payor customer service,… more
    Banner Health (12/11/25)
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  • PFS Representative Patient Referrals

    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
    Whidbey General Hospital (11/26/25)
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  • Patient Services Representative Trauma…

    Corewell Health (Grand Rapids, MI)
    …verifies that prior authorization has been obtained; assists with retroactive insurance denials / appeals . + Responsible for complex EMR/EHR scanning and Right Fax ... Practice and Culture This Patient Service Representative position is responsible for creating a welcoming...- 2 pm. Job Summary As a Patient Services Representative with Corewell Health, you'll play a vital role… more
    Corewell Health (12/05/25)
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  • Patient Services Representative School…

    Corewell Health (Ludington, MI)
    …verifies that prior authorization has been obtained; assists with retroactive insurance denials / appeals . + Responsible for complex EMR/EHR scanning and Right Fax ... for all involved. Job Summary As a Patient Services Representative with Corewell Health, you'll play a vital role...+ Ability to perform the role of Patient Services Representative , Associate when necessary. + Actively participates in safety… more
    Corewell Health (12/13/25)
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  • Patient Account Representative - Medicare,…

    Guidehouse (El Segundo, CA)
    …and three days from home._** **Essential Job Functions** + Account Review + Appeals & Denials + Medicare/Medicaid + Insurance Follow-up + Customer Service ... **Job Family** **:** Patient Account Representative **Travel Required** **:** None **Clearance Required** **:**...**What You Will Do** **:** The **Insurance Patient Account Representative ** **(Hospital Claims)** is an extension of a client's… more
    Guidehouse (12/12/25)
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  • Patient Financial Services Representative

    WellSpan Health (Lewisburg, PA)
    …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 manner while interacting with peers, leaders, patients, and third-party payers to achieve timely payment on accounts in accordance with current government and payer regulations. **Duties and Responsibilities**… more
    WellSpan Health (12/18/25)
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  • Patient Financial Services Representative

    WellSpan Health (York, PA)
    …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 manner while interacting with peers, leaders, patients, and third-party payers to achieve timely payment on accounts in accordance with current government and payer regulations. **Duties and Responsibilities**… more
    WellSpan Health (12/10/25)
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