- MaineGeneral Health (Augusta, ME)
- Job Summary: MaineGeneral Health is seeking a qualified RN Clinical Appeals Specialist to support our Revenue Cycle team by reviewing denied insurance claims ... mission of exceptional patient care Job Description: Position: RN Clinical Appeals Specialist Location: Alfond Center for Health, AugustaSchedule: Full-time… more
- Equitable (Charlotte, NC)
- Appeals Specialist , Disability Claims ( 25000066...management or appeals + Prior experience with appeals , litigation support or legal knowledge is ... will help unlock your potential? Equitable is seeking an influential and dynamic Appeals Specialist to join our Disability and Absence Claims organization. The… 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 ... Appeals process. + Respond to Prior Authorization denials and submit appeals , collecting appropriate clinical support to substantiate the formal response. +… more
- Commonwealth Care Alliance (Boston, MA)
- 011540 CCA- Appeals & Grievances **Position Summary** Appeals and Grievances Specialist supports the Operations Department and the Appeals and Grievances ... well as externally to facilitate timely resolution of all grievances and appeals and ensures compliance with regulations. Additionally, this position is responsible… more
- Centene Corporation (Lansing, MI)
- …in accordance with state and National Committee for Quality Assurance (NCQA) requirements. Support the team to ensure appeals , disputes and reconsiderations are ... reviewed and processed timely. + Performs data entry to support the tracking, logging, and processing of appeals , disputes and reconsiderations in accordance… more
- St. Luke's University Health Network (Allentown, PA)
- …AMA CPT, are assigned to support the services/treatment rendered. The Coding Appeals Specialist also prepares appeal arguments and/or letters to support ... regardless of a patient's ability to pay for health care. The Coding Appeals Specialist retrospectively reviews patient medical records, claims data and coding… more
- Molina Healthcare (New Haven, CT)
- …to ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance ... + Responsible for the comprehensive research and resolution of the appeals , dispute, grievances, and/or complaints from Molina members, providers and related… more
- Ochsner Health (New Orleans, LA)
- …fill our hallways.** **At Ochsner, whether you work with patients** **every day** **or support those who do, you are making a difference and that matters. Come make ... a difference at Ochsner Health and discover your future today!** This job applies clinical expertise as well as knowledge of utilization and discharge planning criteria to review medical information of prior hospitalized patients that are being reviewed via… more
- Commonwealth Care Alliance (Boston, MA)
- 011540 CCA- Appeals & Grievances **Position Summary:** Appeals and Grievances Program Advisor monitors and supports the operations and compliance of the ... Appeals and Grievances department through many NCQA and other...works collaboratively with the AG Representatives and Management to support the development and maintenance of a quality program.… more
- Molina Healthcare (Tacoma, WA)
- **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and correct clinical decisions for appeals outcomes within compliance ... standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical/medical reviews of previously denied cases in which a formal appeals… more
- Amazon (San Francisco, CA)
- …workflow and mail operations at our corporate office. The Correspondence Specialist handles the essential task of processing and mailing secondary insurance ... claims with primary EOBs, preparing and submitting insurance appeals , and managing incoming corporate mail distribution. Key job responsibilities * Print and prepare… more
- Baptist Memorial (Memphis, TN)
- Overview Specialist -Denial Mitigation II RN Job Code: 21432 FLSA Status Job Family: FINANCE Job Summary The Denial Mitigation-Appeal Specialist II RN serves in a ... contacts, communicate with physician clinics to obtain additional documentation to support appeal, collaborate with coding/billing for formulation of appeal with… more
- Baptist Memorial (Memphis, TN)
- Overview Specialist -Denial Mitigation II RN Job Code: 21432 FLSA Status Job Family: FINANCE Job Summary The Denial Mitigation-Appeal Specialist II RN serves in a ... contacts, communicate with physician clinics to obtain additional documentation to support appeal, collaborate with coding/billing for formulation of appeal with… more
- US Courts (Washington, DC)
- Summary The Office 365 Support Specialist (Applications Support Specialist ) position is in the Information Technology Office (ITO) and reports to the IT ... delivering excellence in customer service. Responsibilities The Office 365 Support Specialist (Applications Support ...agency policy. Employees of the United States Court of Appeals for the Federal Circuit are excepted service, at-will… more
- Ellis Medicine (Schenectady, NY)
- …campaigns and long-term strategic planning. + Collaborate with the Foundation Operations Specialist to generate lists for all appeals ensuring that all ... The Annual Fund Specialist is a key member of the Foundation...Fund Campaign with a goal to increase annual giving support . This position requires a dynamic individual with maturity… more
- Robert Half Accountemps (Los Angeles, CA)
- Description We are looking for a skilled Surgery Medical Collections Specialist to join our team. In this role the Surgery Medical Collections Specialist will ... play a critical part in managing insurance follow-ups, addressing medical appeals , and resolving claim denials. This position is ideal for someone with expertise in… more
- State of Colorado (Denver, CO)
- ECMC Enforcement Advisor (Compliance Specialist IV) - Remote/Hybrid Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4887965) Apply ECMC ... Enforcement Advisor (Compliance Specialist IV) - Remote/Hybrid Salary $68,100.00 - $91,200.00 Annually...representatives. Additionally, the position will be called upon to support other unit functions as necessary, including responding to… more
- Fairview Health Services (Minneapolis, MN)
- …east-bank) is looking for a full time, day shift Genomics Support Specialist working Monday-Friday during regular business hours. Schedule ... subject to change based on departmental needs. The Genomics Support Specialist supports the Genetic counselors by acting as a liaison between patients, their… more
- Independent Health (Buffalo, NY)
- …and share knowledge and audit tips across the team. The Clinical & Coding Specialist -Senior will support the leadership in Hospital Audit in accomplishing all ... fosters growth, innovation and collaboration. **Overview** The Clinical & Coding Specialist -Senior will be responsible for reviewing coding and clinical decisions on… more
- State of Colorado (CO)
- …Mental Health Transitional Living (MHTL) Homes Benefits Specialist Work Lead Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4950651) Apply ... Administrator III Mental Health Transitional Living (MHTL) Homes Benefits Specialist Work Lead Salary $57,708.00 - $75,024.00 Annually Location Statewide, CO Job… more