- SUNSHINE ENTERPRISE USA LLC (Orange, CA)
- …Duration: Up to 6 months. Job Summary The Grievance and Appeals Nurse Specialist participates in managing medical appeals and state hearing reviews for ... Job Description Grievance & Appeals Nurse Specialist At Sunshine Enterprise...on clinical guidelines and provides monitoring of cases involving medical decisions and quality of care or service decisions.… more
- UnitedHealth Group (Sugar Land, TX)
- …Connecting. Growing together. The essential functions of a Senior Pharmacy PA/ Appeals Technician are providing expertise and customer service support to members, ... which you start to accrue with your first pay period plus 8 Paid Holidays Medical Plan options along with participation in a Health Spending Account or a Health… more
- SUNSHINE ENTERPRISE USA LLC (Orange, CA)
- …our current job opportunities below. Job Summary The Grievance Resolution Specialist coordinates the Grievance and Appeal resolution process, responds to verbal ... and written Grievances and Appeals from members and/or providers relating to member eligibility...departments such as Customer Service, Provider Operations, Pharmacy, and Medical Management to identify factors necessary for the optimal… more
- Biodesix, Inc. (Louisville, CO)
- …and submit claims and appeals to insurance on behalf of patients. Billing Specialist I will work closely with Client Services and Billing Team to ensure accurate ... Billing experience required, including knowledge of claims processing, denials, and appeals . 1-3 Years of Medical /Laboratory experience preferred Undergraduate… more
- Family Centers (Greenwich, CT)
- Overview Family Centers seeks a detail-oriented Accounts Receivable Specialist to support the Revenue Cycle team in managing outstanding accounts receivable. The ... within two business days. Identify the root cause and initiate resubmissions or appeals as appropriate. Appeals & Payer Communication: Submit appeals … more
- Experity (Atlanta, GA)
- …Benefits - Comprehensive coverage starts first day of employment and includes Medical , Dental/Orthodontia, and Vision. Ownership - All Team Members are eligible for ... take necessary actions to resolve Submit corrected insurance claims and/or appeals , as necessary, with appropriate documentation based on payer guidelines Prioritize… more
- UHS (Riverside, CA)
- …the community since 1935. Our mission is to provide comprehensive multi-specialty medical services in the greater Riverside region. Your passion, inspiration, and ... change lives and transform the delivery of healthcare. Riverside Medical Clinic is the best place to work, practice...all assigned tracer claims 3. Initiate claim review and/or appeals , as indicated on assigned explanation of benefits. 4.… more
- Critical Care Transport (Columbus, OH)
- …as well as background in billing Medicare, Medicaid and commercial insurance including appeals & reconsiderations. Job duties may vary but will include daily data ... entry of ambulance run reports, verifying insurance eligibility, filing appeals with insurance companies, posting insurance payments, and handling inbound/outbound… more
- County of San Diego, CA (San Diego, CA)
- …of Agriculture, Weights and Measures is seeking qualified applicants for INSECT DETECTION SPECIALIST II Interviews will take place on an ongoing basis. Future Salary ... If working independently outdoors and having an interest in plants, insects or horticulture appeals to you, this might be your ideal job! Apply today by clicking the… more
- State of Colorado (Aurora, CO)
- …and enriching professional development opportunities and a wide range of benefits. Medical and dental options are available for permanent employees and their ... Health Savings Account when enrolled in HDHP. Job protected medical leave under the Family Medical Leave...Procedures, 4 CCR 801, for more information about the appeals process. The State Personnel Board Rules and Personnel… more
- Hospital for Behavioral Medicine (Worcester, MA)
- …Job Category Finance Description JOIN OUR TEAM AS A HOSPITAL BILLING SPECIALIST ! Status: Full-Time (On-site only - no remote) Bonus Opportunity: MONTHLY INCENTIVE ... Your Work Matters How will you make a difference? The Hospital Billing Specialist supports our mission by ensuring timely and accurate billing and follow-up of… more
- NavitsPartners (Worcester, MA)
- Job Title: Travel RN - Case Management Specialist Location: Hyannis, MA Assignment Type: Travel Contract Duration: 13 Weeks Shift: Monday to Friday | 8:00 AM - 4:30 ... planning needs Perform assessments and reassessments using InterQual(R) standards Review medical necessity of admissions and escalate concerns per protocol Handle… more
- NewVista Behavioral Health (Cincinnati, OH)
- Job Address: 10123 Alliance Road, Suite 340Blue Ash, OH 45242 Accounts Receivable Specialist In conjunction with some of the areas most advanced physicians and ... clinical teams, Lynx EMS offers high quality medical transport in a safe, growing environment. As an...join an outstanding team! The Role The Accounts Receivable Specialist is responsible for overseeing the billing of all… more
- Axelon Services Corporation (Hometown, IL)
- Job Description: Disability Claims Specialist MAX PAY RATE - $42 per hour Fully Remote 10-20 hours per week Must have at least 3+ years prior LTD/IDI Insurance ... provisions. These calls are used to gather essential details regarding medical condition(s) and treatment, occupational demands, financial information and any other… more
- Trinity Health (Stafford Springs, CT)
- …In addition, assists patients with billing related inquiries if necessary Appeals denied claims for related services, drugs, treatments and supplies. Obtains ... proficiency in the use of computer systems and computer devices Knowledge of medical terminology and medical insurances Position Highlights and Benefits 40 Hours… more
- Quadax (Cleveland, OH)
- …needed to resolve claim rejections. Respond to payer correspondence. Draft appeals for denied claims. Research requests for insurance payment retractions. Research ... Ability to maintain confidentiality. Working knowledge of coding and medical terminology. Excellent written and verbal communication skills. Strong problem… more
- Tenet Healthcare Corporation (Detroit, MI)
- …and client progress to appropriate parties. Refers all concerns regarding medical necessity, inappropriate utilization of resources or quality issues to management ... Remains current on external agency regulations and assists with third party payer appeals as needed. Acts as a resource person and educator to other members… more
- Northwell Health (Chappaqua, NY)
- FlexStaff Our client is seeking a skilled Medical Biller/Accounts Receivable Specialist with a minimum of 2 years of experience in medical billing, including ... OFFICE 3 DAYS A WEEK The candidate MUST HAVE Medical Billing & AR Experience- Experience in Medicare Part...supervision of a Senior Team Lead, the Accounts Receivable Specialist is responsible for superior collection efforts of outstanding… more
- Halo Staffing Group (Laguna Woods, CA)
- …Immediate Interviews - Top Hospitals - An immediate opening for a full time Medical Collections Specialist ! This position is responsible for ensuring accuracy in ... Rate $27-28hr doe About the Organization Our focus on medical recruitment and staffing, experience, and unique sourcing model...insurance claim follow-up, root cause analysis, appeals and denial management. The Collector is highly attentive… more
- Snelling Staffing Services (Baton Rouge, LA)
- Snelling Staffing is in need of a medical collections specialist for a company that has been in the Baton Rouge area for generations. This local clinic maintains ... CALL VOLUME. This position will be a cross between medical billing and medical collections, so candidates...reimbursements assuring contracted fee schedules are being followed Issue appeals to payors for any claims processed incorrectly Post… more
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