- Lincoln Financial (Columbia, SC)
- …for this opportunity. **Requisition #:** 74565 **The Role at a Glance** As an Appeals Specialist you will be responsible for being a product subject matter ... for multiple product lines. You will perform and deliver on appeals claims assignments/projects while simultaneously leveraging and applying knowledge. You will… more
- Cognizant (Columbia, SC)
- **Provider Appeals & Grievances Specialist ** (remote) This is a remote position open to any qualified applicant that lives in the United States. **Summary:** We ... are seeking a dedicated Provider Appeals & Grievance Specialist with 1 to 2 years of experience to join our team. The ideal candidate will have strong technical… more
- TEKsystems (Columbia, SC)
- …MONDAY THROUGH FRIDAY, 9AM-5PM TRAINING WILL BE 4-6 WEEKS CAN TRANSITION TO REMOTE MUST LIVE NO FURTHER THAN 1 HOUR THIS IS 100% DATA ENTRY POSITION, LOOKING FOR ... COMPUTER AND DATA PROCESSING EXPERIENCE. Performs non-medical reviews and processes redetermination letters. *50% Performs non-medical reviews and processes redetermination letters ensuring timeliness and accuracy. *30% Prepares unit reports, analyzes and… more
- Cognizant (Columbia, SC)
- …. Maintain working knowledge of applicable health insurers' internal claims, appeals , and retro-authorization as well as timely filing deadlines and processes. ... Medicare, Medicaid, and third-party guidelines. . Effectively document and log claims/ appeals information on relevant tracking systems . Utilize critical thinking… more
- Datavant (Columbia, SC)
- …and life experiences to realize our bold vision for healthcare. The Specialist is responsible for identifying, analyzing, and resolving claim denials across the ... proficiency in multiple electronic systems and software tools. The specialist serves as a key liaison between coding, billing,...SSI, Availity, and payer portals. + Submit and track appeals with payers, ensuring all documentation and deadlines are… more
- Cardinal Health (Columbia, SC)
- …skills and prioritizes getting the right things done. **The Accounts Receivable Specialist is responsible for processing insurance claims and billing. They will work ... the appropriate system. + Manages and resolves complex insurance claims, including appeals and denials, to ensure timely and accurate reimbursement. + Processes… more
- Evolent (Columbia, SC)
- …Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional cardiology to help ensure the ... of best practices. + Provides clinical rationale for standard and expedited appeals . + Discusses determinations (peer to peer phone calls) with requesting physicians… more