Remote Appeals Specialist II - DRG & Claims Resolution
$50k - $55kMed Review Inc
MedReview is seeking an Appeals Coordinator in the United States to manage appeals and grievances while ensuring timely resolutions. Candidates should have at least 3 years of healthcare experience, with strong problem-solving and analytical skills. Responsibilities include preparing case files, responding to inquiries, and consulting with various team members. The role offers a salary range of $50,000 to $55,000 annually, and comes with comprehensive healthcare benefits, a 401(k) with employer match, and generous paid time off. #J-18808-Ljbffr
$50k - $55k
...solutions including DRG Validation,... ...of the Appeals Department leaders... ...Coordinator level II team member will... ...department. The Appeals Specialist level II... ...timely resolution. Responsible for... ...Experience in inpatient claims, DRG and High-... ...interruptions Remote Work...Remote workClaims- ...hybrid, onsite or remote. While the majority... ...Customer Service, Claims Processors, and Correspondence... ...and provider appeals, grievances,... ...clinical review and resolution of provider appeals... ...emotional level II Ability to demonstrate... ...ICD-10, HCPCS, and DRG coding Preferred...Remote workClaimsFull timeContract workWork experience placementWork at officeLocal area1 day per week
- ...Immediate need for a talented Appeals Specialist II . This is a 06+months contract... ...potential and is located in U.S(Remote). Please review the job description... ...review cases in CENPAS and claims in the AMISYS system to determine resolution on provider reconsiderations. After...Remote workClaimsContract workLocal areaImmediate start
$60.78k
Appeals and Grievances Specialist II Job Category: Customer Service Location: Los Angeles... ...position will provide resolution of complaints in compliance... ...reconsiderations, and complex provider claim disputes. The position is... ..., holidays, a hybrid remote schedule, occasional...Remote workClaimsFull timeLocal areaShift workWeekend work- ...looking for a Technical Denials Management Specialist II within its Revenue Cycle Department.... ..., researching, and resolving claim denials and appeals across various insurance companies. A... ...The position offers flexibility with remote work opportunities but requires candidates...Remote jobClaims
$26.44 - $33.17 per hour
Gemini Legal, based in Rocklin, California, is hiring for a Workers' Compensation Resolution Specialist II who is responsible for managing accounts related to workers' compensation claims. The role requires a strong understanding of applicable regulations and superior negotiation...Remote jobClaimsHourly pay$26.44 - $33.17 per hour
Workers' Compensation Resolution Specialist II About the Role The Workers' Compensation (WC) Resolution... ...associated with workers' compensation claims in outstanding AR greater than 1 year.... ...: West Covina, CA or Rocklin, CA / Remote-Hybrid Schedule: Monday-Friday, 8:00am...Remote workClaimsHourly payWork at officeMonday to Friday- ...A healthcare solutions company is seeking an Appeals Coordinator to support the Appeals Department... ...healthcare experience, a strong background in claims processing, and excellent analytical and communication skills. Remote work options are available along with competitive...Remote workClaims
- ...RCM Specialist II The RCM Specialist II is an individual contributor... ..., helping ensure timely resolution of outstanding balances, clean... ...resolve unpaid or underpaid claims, denials, and aged balances... ...through appropriate action (i.e. appeals, corrections, resubmissions,...Remote workClaims
- ...Description The Spec II Reimbursement is... ...analysis, and problem resolution resulting in... ...aged accounts, process appeals and corrected claims, research and reconcile... ...with Reimbursement Specialists across the enterprise... ...City, UT, 84116, US (Remote) Hourly Salary...Remote workClaimsHourly payFull timeWork experience placement
$22.99 per hour
...nuances. • To verify medical records are present for claims needing medical necessity review. salary: $22.99 - $23 per... ...education: High School Responsibilities Knowledge of appeals, disputes and reconsiderations process preferred. Performs...Remote workClaimsHourly payPermanent employmentTemporary workWork experience placementShift work- ...Overview The Spec II Reimbursement is responsible... ...cause analysis, and problem resolution resulting in increased... ...Work aged accounts, process appeals and corrected claims, research and reconcile credit... ...with Reimbursement Specialists across the enterprise to replicate...Remote workClaims
- ...Revenue Cycle Specialist II Remote Position responsible for submitting and resolving medical claims moderate to high complexity. Must remain... ...party billing, follow-up and appeal requirements for compliant... ...accurate and timely claim resolution. Effectively communicates...Remote workClaimsFull timeWork experience placementWork at office
$23 - $27 per hour
...Reimbursement Specialist II Fully Remote Bristol Hospice - Salt Lake, UT - SALT... ...and Self Pay revenue and resolution of batch errors and bill holds... ...on progress of claims and follow up status Submit... ...Prepare/review and submit appeal information as needed to payor...Remote workClaimsHourly payFull timeWork at officeLocal areaShift work- ...Labor Relations Specialist The Office of Labor Relations... ...disputes and appeal procedures involving bargaining... ...Alternative Dispute Resolution (ADR): Advising management... ...Labor Relations Specialist II: Two (2) years of... ...more information and to claim employment preference,...Remote workClaimsContract workSecond jobWork at officeLocal areaNight shiftWeekend work
- ...opportunity for a Revenue Cycle Specialist II to support our Billing Team... ...follow-up actions on claims denied for eligibility-related... ...accurate reimbursement and account resolution. Responsibilities:... ...resolve denied claims and submit appeals. Call payers to determine...ClaimsFull timeContract workTemporary workLocal areaImmediate startMonday to Friday
- ...looking for a PFS Government A/R Specialist II. Key Responsibilities Accurately submit insurance claims for all payer types and... ...regulations Perform A/R follow-up, appeals, and daily reconciliation of... ...compliant workspace and a high-speed internet connection for remote work...Remote workClaimsTemporary work
- Revenue Cycle Specialist II (Physician Billing) Job Description... ...multi-specialty claims to third party payors,... ...effectively bill, submit appeals and collect monies... ...research in order to bring resolution. You will work with... ...Angeles, CA, 90048, US (Remote) #J-18808-Ljbffr...Remote workClaims
- ...and dedication. Job Summary The Appeal Specialist II reviews, analyzes, and resolves insurance... ...to ensure timely and thorough appeal resolution and supports initiatives that improve... .... Understanding of insurance claims processing and denial management workflows...Remote workWork at officeLocal area
- ...Supporting a high-volume revenue cycle process, the full-time California Resolution Specialist will manage claims follow-up, perform appeals submissions, and navigate payer portals while working remotely. Key responsibilities Complete timely claims follow-up actions,...Remote workClaimsFull time
- ...Summary Provides entry level support for claims activities including reviewing and... ...provider complaints, and communicating resolution to members or authorized representatives... ...Enters denials and requests for appeals into information system and prepares documentation...Remote workClaimsWork at officeWeekend work
$350 per month
...Appeals Specialist I Will the position be 100% remote? Yes- please source candidates from any one of the following 15... ...provider complaints and communicating resolution to members and provider (or... ...timelines are met. Research claims appeals and grievances using support...Remote workClaimsContract work$21.16 - $38.37 per hour
...to apply for the Medicare Appeals & Grievances Specialist (PST Hours) role at Molina... ...Healthcare . This position is remote and will be working... ...comprehensive research and resolution of appeals, disputes, grievances... ...are met. Researches claims appeals and grievances using...Remote workClaimsHourly payFull timeContract workWork experience placementWork at office$22 - $25 per hour
...Our Revenue Cycle Specialist directly contributes to our... ...through Thursday and remote on Mondays and Fridays... ...reimbursement, and driving resolution to optimize revenue... ...primary and secondary claims submission Work and... ...investigations & appeals Escalation at plan...Remote workClaimsWork experience placementWork at officeLocal areaMonday to Friday- ...reviewing and resubmitting claims to third party payors, performing... ...The Revenue Cycle Specialist II: Participates in department... ...assists other team members with resolution of accounts when needed.... ...and efficiently. *Approved Remote States: Arizona, California,...Remote workClaims
- ...Kids for the Future is seeking a DRG Appeals Review Nurse to analyze and appeal denied MS-DRG and APR-DRG accounts. The ideal candidate... ...extensive clinical experience. Key responsibilities include reviewing claims for appeal potential, writing detailed appeal letters, and...Remote workClaimsWork from home
- ...PositionResponsible for processing expedited appeals: those that are complex in... ...Expedited Appeal unit, the Specialists are required to work weekends... ...activity related to the claims, payment, or service in... ...authorization effectuation and resolution of cases.Perform necessary...Remote workClaimsHourly payContract workWeekend work
$25 - $28 per hour
...Grievance & Appeals Specialist Our Grievance & Appeals Specialist is responsible... ..., appeals, and provider claim disputes across the Health... ...thorough case review and resolution. Key responsibilities include... ...experience. We are open to remote work in Wisconsin. Employees...Remote workClaimsHourly payFor contractorsWork at officeLocal areaImmediate start2 days per week- ...Physician Coding Specialist II Hybrid Under the direction of the Revenue... ...contact and negotiates appropriate resolutions to ensure timely payments of outstanding claims. What You Will Do:... ...Professional Travel: No Remote Work: Hybrid Job Posting: May...Remote workClaimsFull timeWork experience placementWork at office
- ...accurate follow-up to address and improve resolution of payment delays, updating/reprocessing claims, submitting reconsiderations/appeals within proper filing timeframe to... ...services rendered. Denials and appeals specialists must be knowledgeable of payer requirements...Remote workClaimsWork experience placementWork at officeShift work
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