- Equitable (Charlotte, NC)
- Appeals Specialist , Disability Claims (Group Insurance Appeals Claims Experience Required) ( 25000066 ) **Primary Location** : UNITED ... Appeals Specialist to join our Disability and Absence Claims organization. The Appeals , Complaints, and Litigation Specialist is responsible for… more
- Lincoln Financial (Phoenix, AZ)
- …for this opportunity. **Requisition #:** 74565 **The Role at a Glance** As an Appeals Specialist you will be responsible for being a product subject matter ... reviews for multiple product lines. You will perform and deliver on appeals claims assignments/projects while simultaneously leveraging and applying knowledge.… more
- Serco (NM)
- **Position Description** We are looking for a skilled and detail-oriented Claims Appeals Specialist to join our team. The successful candidate will have at ... claims processing and communication, we want to hear from you. **As a Claims Appeals Specialist , you will:** + * Conduct detailed evaluations of… more
- TEKsystems (Hartford, CT)
- Job Posting: Healthcare Data Entry Specialist - Grievance & Appeals (Remote - East Coast Preferred) Job Title: Healthcare Data Entry Specialist - Grievance & ... Position Overview We are seeking a detail-oriented and experienced Healthcare Data Entry Specialist - Grievance & Appeals to support a critical project for… more
- CenterLight Health System (NY)
- …effectiveness of the claims department by timely and accurate processing of claims appeals and performing claims audit, ensuring payment integrity and ... JOB PURPOSE: The Claim Appeals and Audit Specialist will play...measurable outcomes. JOB RESPONSIBILITIES: + Perform end to end claims appeals review process. Track appeals… more
- AscellaHealth (Berwyn, PA)
- What we are looking for Optime Care seeks a Prior Authorization and Appeals Specialist for our Berwyn, PA location. We are looking for someone who is passionate ... manages the process of receiving, researching, and resolving prior authorizations and appeals issues with health insurance companies, including any escalated step of… more
- Community Health Systems (Sarasota, FL)
- **Job Summary** The Appeals Specialist I is responsible for reviewing patient accounts denied for insurance reimbursement or paid incorrectly and following ... to resolve discrepancies and improve reimbursement rates. As an Appeals Specialist I at Community Health Systems...and bonus where eligible. **Essential Functions:** + Reviews denied claims and incorrect payments, initiating the appeals … more
- TEKsystems (Charlotte, NC)
- …or administrative experience, preferably in healthcare or insurance. + Familiarity with appeals , grievances, or claims processing is highly desirable. + Strong ... Position Overview: We are currently seeking dedicated and detail-oriented Grievance & Appeals Data Entry Specialists to support our team. This role is ideal for… more
- Aerotek (Tampa, FL)
- **Description** PURPOSE: The Clinical Appeals Specialist completes research basic analysis and evaluation of member and provider disputes regarding adverse and ... adverse coverage decisions. The Clinical Appeals Specialist utilizes clinical skills and knowledge of all applicable State and Federal rules and regulations that… more
- FlexStaff (Bronx, NY)
- **Req Number** 158358 FlexStaff is seeking a Temp to Perm Claims Specialist for our client, a non-profit healthcare organization providing home and ... community-based healthcare and services for the elderly. The Claims Specialist will support department operations related to provider communication, pended claim… more
- HCA Healthcare (Salem, VA)
- …want to join an organization that invests in you as a Workers Compensation Claims Resolution Specialist ? At Parallon, you come first. HCA Healthcare has ... the opportunity to make a difference. We are looking for a dedicated Workers Compensation Claims Resolution Specialist like you to be a part of our team. **Job… more
- Kelly Services (Glastonbury, CT)
- **Job Title:** Medical Claims Processor / Medical Claims Specialist **Pay Rate:** $23.00/hour **Schedule:** 11:30 AM - 8:00 PM or 8:30 AM-5:00 PM **Language ... Summary:** We are currently seeking a detail-oriented, organized, and compassionate **Medical Claims Processor / Medical Claims Specialist ** to join… more
- Axis (Alpharetta, GA)
- …identity or expression, national origin or ancestry, citizenship, physical or mental disability , age, marital status, civil union status, family or parental status, ... selection process. **Job Description** AXIS is seeking a **_Claims Specialist - Management Liability_** to join our North America... - Management Liability_** to join our North America Claims team. The selected candidate will work closely with… more
- CVS Health (Augusta, ME)
- …And we do it all with heart, each and every day. **Position Summary** The **Senior Claims Benefit Specialist ** will review and adjust SF ( _self-funded_ ), FI ( ... _fully insured_ ), Reinsurance, and/or RX claims . They will adjudicate complex, sensitive, and/or specialized claims in accordance with claim processing… more
- CVS Health (Montgomery, AL)
- …handle customer service inquiries and problems. **Additional Responsibilities** + Reviews pre-specified claims or claims that exceed specialist adjudication ... day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject… more
- TEKsystems (Miami, FL)
- 100% REMOTE DATA ENTRY SPECIALIST THIS IS A CONTRACT JOB OPPORTUNITY FROM JULY 28 - DECEMBER OPPORTUNITY TO WORK FOR ONE OF THE LARGEST HEALTHCARE INSURANCE ... + Ability to meet deadlines POSITION OVERVIEW: EmblemHealth has a backlog of 10,000 appeals and grievances so these Data Entry Reps will be filtering through the … more
- Robert Half Accountemps (Fort Wayne, IN)
- …are offering a contract to permanent employment opportunity for an Insurance Follow-Up Specialist in FORT WAYNE, Indiana. This role is in the healthcare industry and ... will involve follow-ups on medical claims . The workplace environment is business casual and requires...Manage Insurance Denials and Payer Denials, and handle Medical Appeals . * Leverage expertise in Insurance Follow-up, Claim Denials,… more
- Johns Hopkins University (Middle River, MD)
- … III_** to be **r** esponsible for the collection of unpaid third-party claims and independent resolution of complex appeals , using various JHM applications ... Communicates with payers to resolve issues and facilitate prompt payment of claims . Communicates with providers regarding appeals and medical policy denials… more
- Johns Hopkins University (Middle River, MD)
- … III_** who will be responsible for the basic collection of unpaid third-party claims and standard appeals , using various JHM applications and JHU/ PBS billing ... on an understanding of the outpatient registration process. The Specialist will use an understanding of claims ...etc.) as needed and submits to third-party payers. + Appeals rejected claims and claims … more
- Johns Hopkins University (Middle River, MD)
- …Cycle Specialist_** to be responsible for the basic collection of unpaid third-party claims and standard appeals , using various JHM applications and JHU/ PBS ... on an understanding of the outpatient registration process. The Specialist will use an understanding of claims ...etc) as needed and submits to third-party payers. + Appeals rejected claims and claims … more