- HCA Healthcare (Orem, UT)
- …**Introduction** Do you want to join an organization that invests in you as a Medical Insurance Claims Appeals Representative? At Parallon, you come ... you have the opportunity to make a difference. We are looking for a dedicated Medical Insurance Claims Appeals Representative like you to be a part of… more
- Molina Healthcare (Midvale, UT)
- …the likelihood of a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge, ... Experience in the specific programs supported by the plan such as Utilization Review, Medical Claims Review, Long Term Service and Support, or other specific… more
- Humana (Salt Lake City, UT)
- … Medical Director (CMD) relies on medical background to review health claims and preservice appeals . The Corporate Medical Director works on problems ... Medical utilization management experience + Working with health insurance organizations, hospitals and other healthcare providers, patient interaction, etc.… more
- Humana (Salt Lake City, UT)
- …Corporate Medical Director relies on medical background and reviews health claims and preservice appeals . The Corporate Medical Director works on ... + Medical utilization management experience, + working with health insurance organizations, hospitals and other healthcare providers, patient interaction, etc. +… more
- R1 RCM (Salt Lake City, UT)
- …Denials Consultant, you will represent healthcare providers in their disputes with medical insurance carriers and managed care organizations at all stages ... experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines...contractual provisions and applicable state and federal laws, writing appeals and letters to insurance companies to… more
- University of Utah Health (Salt Lake City, UT)
- … medical advancement, and overall patient outcomes. **Responsibilities** + Performs insurance follow-up and denial resolution on outstanding claims . + ... experience, or equivalency. **Qualifications (Preferred)** **Preferred** + Understanding of Medical billing terminology or equivalent. + Demonstrated claims … more
- Humana (Salt Lake City, UT)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance , other healthcare providers, clinical group practice management. + **A… more
- CVS Health (Salt Lake City, UT)
- …Qualifications** + 3+ years of experience with claims and/or health insurance . + Strong familiarity with medical terminology, self-funding, and/or ERISA ( ... **Required Qualifications** + 1+ years of experience with healthcare, specifically in appeals , claims , and/or compliance, as well as benefit interpretation. +… more
- Cardinal Health (Salt Lake City, UT)
- …billing queue as assigned in the appropriate system. + Manages and resolves complex insurance claims , including appeals and denials, to ensure timely and ... **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work...benefits and programs to support health and well-being. + Medical , dental and vision coverage + Paid time off… more
- R1 RCM (Salt Lake City, UT)
- …you will conduct root cause analysis to draft appeal letters to resolve any insurance company medical denials and perform adjustments and closures. To thrive in ... experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines...contact payers to learn the status of previously resubmitted claims , written appeals , or updates on incoming… more
- R1 RCM (Salt Lake City, UT)
- …day, you will conduct root cause analysis to craft appeal letters to resolve any insurance company medical denials. To thrive in this role, you must excel in ... experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines...contact payers to learn the status of previously resubmitted claims , written appeals , or updates on incoming… more
- Intermountain Health (Salt Lake City, UT)
- … follow up, reconsideration and appeals , response to denials, and re-bills of insurance claims , and all aspects of insurance follow-up and collections. + ... Submit requested medical information to insurance carrier. Responsible for the analysis and necessary corrections of invoices or accounts and maintaining work… more
- Cognizant (Salt Lake City, UT)
- …other teams. **In this role, you will:** + Review and resolve denied or rejected medical claims due to coding errors, ensuring accurate coding and billing based ... following benefits for this position, subject to applicable eligibility requirements: . Medical /Dental/Vision/Life Insurance . Paid holidays plus Paid Time Off .… more
- Cardinal Health (Salt Lake City, UT)
- …+ Clear knowledge of Medicare (A, B, C, D) + 1-2 years of Pharmacy and/or Medical Claims billing and Coding work experience is preferred + 1-2 years of ... the patient journey. + Support healthcare providers with Prior Authorization and Appeals submission to Insurance carrier. + Exhibit effective communication and… more
- Alight (Salt Lake City, UT)
- …on external legal requests (eg, lawyers requesting plan documentation for denied medical claims ) + Completing benefits surveys (eg, Working Mothers Survey, ... with employees + Completing employee benefit verification forms (eg, Medicare forms, life insurance forms / retiree death claims , LTD employer conversion forms,… more
- Affordable Care (American Fork, UT)
- …Dentrix, handling dental office finances, full insurance billing process (including claims submission, appeals , and denial management) and being able to ... do your job well. **Additional benefits include** , group medical and dental insurance , vision insurance...check in/out, discussing treatment and financial arrangements, handling the insurance billing process ensuring all claims are… more
- Highmark Health (Salt Lake City, UT)
- …medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary ... through paid clams review. + Participate as pharmacy representative in onsite member appeals and grievances sessions. + Serve as a resource for technical staff. +… more
- Cardinal Health (Salt Lake City, UT)
- …pharmacy insurance benefit practices, preferred + 1-2 years of Pharmacy and/or Medical Claims billing and Coding work experience + 1-2 years experience with ... + Follow through on all benefit investigation rejections, including Prior Authorizations, Appeals , etc. All avenues to obtain coverage for the product must be… more
- Evolent (Salt Lake City, UT)
- …culture. **What You'll Be Doing:** **Analyst, Client Analytics** Integrate and analyze claims and enrollment data from multiple sources using SAS and SQL programs. ... innovative analytics solutions that drive decision-making for clients by performing medical economics analyses to determine cost and utilization drivers. Showcase… more