- Martin's Point Health Care (Portland, ME)
- …Place to Work" since 2015. Position Summary Job Description Position Summary: The Appeals Specialist (Medicare or US Family Health Plan) is responsible for ... in accordance with CMS requirements + Cross-trains with US Family Health Plan Appeals Specialist to perform functions as needed US Family Health Plan Focus Key… more
- Universal Health Services (Richmond, VA)
- …The Atlantic Region CBO is seeking a dynamic and talented Senior Appeals Specialist . The Senior Appeals Specialist ... identified during the billing of claims and the follow-up on the clinical appeals performed by the facilities. Key Responsibilities include: + Responsible for higher… more
- Universal Health Services (Richmond, VA)
- …Rico and the United Kingdom. The Atlantic Region CBO is seeking a dynamic and talented Appeals Specialist . The Appeals Specialist is responsible for the ... identified during the billing of claims and the follow-up on the clinical appeals performed by the facilities. Key Responsibilities include: + Responsible for … more
- Natural Resources Conservation Service (Champaign, IL)
- Summary The incumbent serves as an mid-level Appeals Specialist responsible for program management support of the conservation quality assurance and the ... administrative appeals process involving NRCS in the assigned state working...primary point of contact in the state for programmatic appeals dealing with conservation programs and conservation compliance provisions… more
- Universal Health Services (Bonham, TX)
- …day. TMC Bonham is managed by Texoma Medical Center, subsidiary of UHS. The Appeals Specialist is responsible for appealing all insurance denials and prepare ... in compliance with Managed Care contracts and government fee schedules. The Appeals Specialist will obtain, manipulate, and analyze data from a variety of… more
- Alameda Health System (San Leandro, CA)
- Care Management Clinical Appeals Specialist + San Leandro, CA + Finance + Patient Financial Svcs - Facil + Full Time - Day + Business Professional & IT + Req ... Coordinates and executes the appeal process for all AHS facilities clinical appeals and third party audits. **DUTIES & ESSENTIAL JOB FUNCTIONS:** NOTE: The… more
- University of Utah (Salt Lake City, UT)
- …Number** PRN38907B **Job Title** Outpatient/Provider Coder Level 3 **Working Title** Medical Appeals Coding Specialist SR **Job Grade** E **FLSA Code** Nonexempt ... Coder-Hospital ( CPC -H), Certified Professional Coder-Payer ( CPC -P), Certified Coding Specialist ( CCS ), Certified Coding Specialist - Physician Based (… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II (ALD) Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los ... achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will...Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve member and… more
- University of Virginia (Charlottesville, VA)
- …+ Works complex denials with a high degree of accuracy and timeliness. Responds to inquiries from patients, clinical departments, and third parties by way of ... telephone, written correspondence and personal contacts. + Adds/corrects registration, insurance, and demographic data in the EPIC billing system to ensure accurate records. + Analyzes and prepares applicable adjustments to physicians' fees in compliance with… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Quality Auditing Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: ... achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Quality Auditing (QA) Specialist ...Center Appeals and Grievances Quality Auditing (QA) Specialist II is responsible for assisting the Appeal and… more
- Sanford Health (Sioux Falls, SD)
- …interpretation of policies, and handling of correspondence related to denials and appeals submitted by providers and members. Must administer benefits in accordance ... demonstrated understanding of regulatory requirements and timeframes. Intake and coordinate appeals and denials, and then make determinations based on member policy… more
- Internal Revenue Service (Fresno, CA)
- …CAREERS? Visit us on the web at www.jobs.irs.gov Responsibilities WHAT IS THE APPEALS DIVISION? A description of the business units can be found at: ... Vacancies will be filled in the following specialty areas: Office of Appeals Case and Operations Support Account and Processing Support Special Programs AARS… more
- TEKsystems (Plano, TX)
- Required: + 2+ years of Insurance follow-up, denials/ appeals experience (Medical A/R) + Hospital/facility collections experience Description: Responsible for A/R, ... Responsible for managing CBO Aging Report properly to insure appeals are followed up timely to prevent past filing...Responsible for timely medical records requests and submission of appeals * Maintain adequately trained staff to achieve daily… more
- Trinity Health (Farmington Hills, MI)
- …Responsible for leveraging clinical knowledge and standard procedures to track appeals through first, second, and subsequent levels, and ensuring timely filing ... of appeals as required by payers, in addition to promoting...and reviews findings with all levels of Payment Resolution Specialist for further review. Serve as a resource to… more
- Trinity Health (Farmington Hills, MI)
- …as part of the payment resolution team that receives, analyzes, and appeals denials received for an assigned PBS location. Reviews, researches and resolves ... knowledge of state/federal laws as they relate to contracts and the appeals process. Investigates and addresses overpayment and underpayment accounts with the… more
- Trinity Health (Farmington Hills, MI)
- …Responsible for leveraging coding knowledge and standard procedures to track appeals through first, second, and subsequent levels, and ensuring timely filing ... of appeals as required by payers. in addition to promoting...and reviews findings with all level of Payment Resolution Specialist for further review. Takes initiative to continuously learn… more
- Trinity Health (Farmington Hills, MI)
- …Maintains knowledge of state/federal laws as they relate to contracts and the appeals process. Assists in training Payment Resolution Specialist I colleagues ... clinical support, as well as to ensure timely follow-up and action for account appeals . + Works with Patient Access and other necessary parties to resolve account… more
- Johns Hopkins University (Middle River, MD)
- …edits reports, file or pull EOB batches. + Identifies and escalates non-standard appeals to a higher-level specialist . + Informs the supervisor / Production ... for the basic collection of unpaid third-party claims and standard appeals , using various JHM applications and JHU/ PBS billing applications. Communicates… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Coordinator I Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, ... net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Coordinator I supports the Customer Solution Center Appeals … more
- Office of the Secretary of the Interior (Arlington, VA)
- …to the Senior Executive Service (SES). Responsibilities The Director Office of Hearings and Appeals is located in the Office of the Secretary of Interior at the ... management and administrative responsibilities with respect to the hearings and appeals functions of the Department in accordance with existing policies,… more