- OMNI MANOR INC (Warren, OH)
- …to maximize patient benefits. Pre-certification of admissions/ readmissions. Daily updates with insurance companies. Insurance appeals , payment appeals ... OH Description Works with the admissions team, patient/family and insurance companies to promote timely admissions utilizing appropriate precertification process… more
- Actalent (Boston, MA)
- …Review Clinician Job Description As a Clinical Review Clinician specializing in appeals , you will be responsible for preparing case reviews for Medical Directors ... by thoroughly researching appeals , reviewing applicable criteria, and analyzing the basis for...Plan - Pre-tax and Roth post-tax contributions available *Life Insurance (Voluntary Life & AD&D for the employee and… more
- UnitedHealth Group (Wausau, WI)
- …experienced RNs with solid interpersonal skills to join our team. The Clinical Appeals RN will be responsible for reviewing appeals and provider inquiries ... prescribed by the plan benefits. As a post-service clinical appeals RN, you will be putting your detective skills...this requirement) Preferred Qualifications: BSN degree or higher Health Insurance industry experience Knowledge of ICD - 10 /… more
- UnitedHealth Group (Cypress, CA)
- …individual case review for appeals and grievances for various health plan and insurance products, which may include PPO, ASO, HMO, MAPD, and PDP. The appeals ... the US as you take on some tough challenges. Primary Responsibilities: The Appeals and Grievances Medical Director is responsible for ongoing clinical review and… more
- Stony Brook University (Stony Brook, NY)
- …services. Perform minor joint procedures. Work with clinic staff together for insurance appeals and pre-authorizations as necessary. Coordination with clinic ... staff of patient care for both outpatients and inpatients related to rheumatologic care, including national and international referrals. Perform consents, including for genetic testing. Cover physicians during their absence as necessary. Perform other duties… more
- Dane Street, LLC (Mclean, VA)
- …Independent Medical Exams (IME), you will utilize clinical expertise and reviews insurance appeals , and prospective and retrospective claims. The Physician ... Reviewer will provide an interpretation of the medical necessity of services provided by other healthcare professionals in compliance with client specific policies, nationally recognized evidence-based guidelines, and standards of care. Requirements Reviews… 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 ... for the purpose of appealing proposed DRG and coding changes by insurance providers or their respective auditors JOB DUTIES AND RESPONSIBILITIES: Conduct… more
- UofL Health (Louisville, KY)
- …admissions Codes all diagnosis and procedures appropriately to obtain insurance authorizations/ appeals Explains surgical procedures/processes to patients and ... new and established patient appointments; register patients by obtaining paperwork, insurance cards, and copayments Other Functions: Maintains clean exam rooms… more
- Regal Medical Group, Inc. (Northridge, CA)
- …Employer-paid comprehensive medical, pharmacy, and dental for employees Vision insurance Zero co-payments for employed physician office visits Flexible Spending ... Account (FSA) Employer-Paid Life Insurance Employee Assistance Program (EAP) Behavioral Health Services Savings and Retirement: 401k Retirement Savings Plan Income… more
- Riccobene Associates Family Dentistry (Goldsboro, NC)
- …platform As requested, assist Revenue Cycle Management (RCM) as needed with insurance denial appeals , credentialing, coding, or other billing issues identified ... an accredited dental school Valid state dental license and malpractice insurance Valid DEA license Current CPR Certification Essential Requirements Strong… more
- Experity (Machesney Park, IL)
- …find the root cause and take necessary actions to resolve Submit corrected insurance claims and/or appeals , as necessary, with appropriate documentation based on ... between $17 and $19.50 dependent upon experience Responsibilities: Manage outstanding insurance AR for assigned clients along with providing trending information to… more
- Outreach Community Health Centers, Inc (Milwaukee, WI)
- …as required. Perform additional duties as assigned. Experience in filing claim appeals with insurance companies to ensure maximum entitled reimbursement. ... Experience with Medicare and Medicaid claims is preferred. Familiarity with insurance processes, managed care, PPOs, FQHC billing, and Milwaukee County systems… more
- DNA Comprehensive Therapy Services (Fort Myers, FL)
- …for delay in payment. Answer patient questions regarding their balance. Filing appeals with insurance companies Posting appropriate non-payment from insurance ... The Medical Collector communicates with insurance companies and governmental entities to ensure maximum...a timely manner. Review and handle all correspondence from insurance companies and patients. ESSENTIAL DUTIES AND RESPONSIBILITIES: Works… more
- Woundlocal (Austin, TX)
- …to the medical team, ensure timely submission to payers, review claim denials, submit appeals , and bill secondary insurance . All claims are made for advanced ... professional with extensive experience in Medicare billing and commercial and federal insurance benefits verification. Must be able to perform, train, and oversee… more
- Torrance Memorial Medical Center (Torrance, CA)
- …Rep is responsible for reviewing denied claims and carrying out the appeals process. Works to maintain third-party relationships, including responding to inquiries, ... Knowledgeable of state/federal laws that relate to contracts and to the appeals process. Assists the Denials Management Senior Analyst with reports and provides… more
- UF Health (Jacksonville, FL)
- …claims submissions. Registers patients and completes necessary documentation including insurance verification and benefits determination. Research charges to submit ... by physicians and non-physician providers maintaining timely claims submissions and timely Appeals process as defined by individual payors. Review and facilitate the… more
- OneOncology (Nashville, TN)
- …related to shared service lines of business including claim rejections, denials, and appeals . Review and interpret insurance policies and regulations related to ... billing and collections, as well as a strong understanding of insurance authorizations, coverage and benefits, reimbursement processes and regulations related to… more
- Randstad (Worcester, MA)
- …requirements and individual expectations. This role serves to administer the appeals and grievance process as outlined in handbooks, departmental policies, and ... standards. This role is responsible for triaging and assigning all incoming appeals and grievances and will also provide administrative support to the department.… more
- Affordable Dentures & Implants (Colorado Springs, CO)
- …skills. Experience working with Dentrix, handling dental office finances, full insurance billing process (including claims submission, appeals , and denial ... job well. Additional benefits include , group medical and dental insurance , vision insurance , life insurance , flexible spending (health and dependent care),… more
- BlueCross BlueShield of South Carolina (Columbia, SC)
- …as needed to resolve inquiries. Reviews and adjudicates claims and/or non-medical appeals . Determines whether to return, deny or pay claims following organizational ... in the South Carolina community. We are the largest insurance company in South Carolina and much more. We...responsibilities include review and adjudication of claims and/or non-medical appeals , determining whether to return, deny or pay claims… more
