Medical Claims Follow-Up & Appeals Specialist
360care
360care is seeking a Claims Specialist in Louisville, KY, to manage medical claims processing including follow-up, rebilling services, and eligibility verification. The ideal candidate will possess a high school diploma with relevant experience in a medical office setting, specifically with HMO/PPO, Medicare, and Medicaid systems. Strong communication and problem-solving skills are essential for this role, as you'll interact with patients and insurance payers, ensuring accurate billing and claims management. #J-18808-Ljbffr 360care
- ...Claims Follow Up Specialist This position is responsible for the timely follow up of technical or professional medical claims to insurance companies that have been denied, left pending or... ...and process request. Research and appeal denied claims. Responsible for rebilling...MedicalClaimsWork at office
$23 per hour
Pharmacy Prior Authorization Specialist - CareMed Specialty Pharmacy... ...training. Company Benefits Medical; Dental; Vision 401k with a... ...addressing and rectifying rejected claims and conducting necessary... ...prior authorization requests and appeals with insurance carriers....MedicalClaimsFull timeTemporary workLocal areaRemote workRelocation package- ...and oversee Facility clinical claim denials by developing strategies... ...as related issues such as medical necessity, experimental determinations... ...: Oversee clinical appeals team to ensure timely and quality... ...skills to ensure timely follow-up and accurate record keeping...MedicalClaimsShift workDay shift
- ...Nurse Appeals- Licensed Nurse Locations: Mason, OH; Cincinnati... ...investigating and processing and medical necessity appeals requests... ...preferred. Experience reviewing claims and researching CPT codes or... ...explanation. Elevance Health will also follow all relevant federal, state...MedicalClaimsFull timeTemporary workWork at officeLocal areaShift workWeekend work1 day per week
- ...Clinical Reviewer to utilize clinical knowledge for validating medical claims and ensuring compliance with state and federal regulations.... ...This role involves conducting medical reviews of authorization appeals, working closely with medical directors, and ensuring the...MedicalClaims
$29.05 - $67.97 per hour
...review of documentation to ensure medical necessity and appropriate... ...the medical record and claim submitted support correct coding... ...retrospective, and concurrent review of appeals for denied prior... ...CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager...MedicalClaimsHourly payWork experience placementWork at office- ...five hospitals, four medical centers, nearly 200 physician... ...include research and follow up on specialty or... ...specific denials and appealing denials as needed, charge... ...Research and resolve claim denials or rejections... ...Patient Financial Specialists, concerning patients requesting...MedicalClaimsWork at officeShift workDay shift
$100k - $180k
...all types of general liability claims, premises liability and professional lines including medical malpractice and assisted... ...mediation, arbitration, trial, and appeal, we provide comprehensive legal... ...this role, you must meet the following requirements: Admitted to practice...MedicalClaimsInterim roleWork at office$28 - $32 per hour
...positions): ~ Accrued Paid Time Off ~ Medical, Dental, Vision, and Life Insurance ~40... ...Do: In this role, you will conduct claims investigations by gathering evidence, interviewing... ...Proficient reading skills and ability to follow directions required ~ Must be able to...MedicalClaimsHourly payFull timePart timeWork at officeRemote workFlexible hours$20.18 - $31.39 per hour
...Nonexempt Job Summary: The following statements are intended to... ...families) pursuing disability claims and other benefits from the United... ...the United States Court of Appeals for Veterans Claims. Learn... ...pertinent data, including medical records, to identify and/or assess...MedicalClaimsFull timePart timeApprenticeshipWork at officeRelocation$50k
...and adhere to critical medications. Backed by proven... ...authorizations / denial appeals, and assisting patients... ...case management will follow the guidelines set forth... ...activities, including claims status, payments, and... ...Authorization Certified Specialist), CHES (Certified...MedicalClaimsFull timeTemporary workWork at officeImmediate startRemote workWork from home- ...inpatient and outpatient facility claims, including itemized bill line... ...and to withstand provider appeals. Apply established QA... ...Experience in one or more of the following: payment integrity, clinical... ...Strong ability to interpret medical records and connect documentation...MedicalClaimsTemporary workWork at officeLocal area2 days per week1 day per week
- ...Assist in resolving billing edits that are holding patient claims from billing, by reviewing medical records and other applicable documentation. Position... .... Employees in this role must reside in one of the following states to be considered for fully remote positions: Kentucky...MedicalClaimsRemote job
$700 per month
...Independent Medical Consultant Opportunity: Maximize Your Earnings and Flexibility Are... ...consultants performing essential VA Claim (C&P) Exams. Attractive Compensation... ...documentation, eliminating the burden of follow-up care and ongoing treatment. Professional...MedicalClaimsLocal areaFlexible hoursWeekend workWeekday work- ...and credit memos that are not related to mill claim issues. 4. Handle any questions, issues, or... ...offer: Insurance: Affordable plans for medical, dental, vision, and wellbeing on the first day of the month following your start date Employer-Paid dental with available...MedicalClaimsBi-weekly payContract workTemporary workWork at officeLocal areaFlexible hours
- ...health system with five hospitals, four medical centers, nearly 200 physician practice locations... ...and every day. The Precertification Specialist sets the precedence to ensure a positive... .../setting up peer to peers and/or appeals for providers in a timely and professional...MedicalLocal areaShift workDay shift
- ...strategy. Analyze pharmacy claims, drug pricing, rebate models,... ...operations by: Managing pricing appeals, coordinating with Maxor... ...project manager with excellent follow-through and organizational discipline... ...a $850 individual annual medical deductible and $25 office...MedicalClaimsFull timeTemporary workWork at officeRemote workWork from home
$50k
...Valeris Commercialization Specialist Valeris is a fully... ...adhere to critical medications. Backed by proven industry... ...payer coverage or claim submission process... ...submit pre-determinations, appeals and/or peer to peer... ...Ensure all SOPs are followed with consistency Perform...MedicalClaimsFull timeTemporary workWork at officeLocal areaImmediate startHome office- ...Health Record Maintenance Specialist Maintenance of Health Record 1. Understands the electronic health... ...the security/privacy of the EMR and paper medical records to ensure that confidentiality is maintained by following Federal, HIPAA, Joint Commission regulations,...MedicalFull timeWork at office
- ...completing record location, retention and transfer. Protects the security/privacy of the EMR and paper medical records to ensure that confidentiality is maintained by following Federal, HIPAA, Joint Commission regulations, and SCS procedure. Compiles and maintains existing...MedicalFull timeWork at office
- ...resources as needed. # Assist with Administrative tracking and follow-up activities related to the Student Loan Coaching Program.... ...for eligible employees including ~ Defined Pension Plan ~ Medical ~ Dental ~ Vision ~ Basic Life Insurance ~ Short-Term and...MedicalTemporary workWork at officeRemote workFlexible hours
- ...managed care authorizations for assigned facilities following the managed care companies' requirements. Pre-Cert Specialist is responsible for obtaining the appropriate... ...Perks include the following and more! ~ Medical, Dental and Vision – Voluntary Life/Disability...MedicalMonday to FridayFlexible hours
- ...fulfilling a single patient’s request for their medical records to powering the AI revolution in... ..., part-time role as a Chart Retrieval Specialist. This role involves visiting various... ..., quality work, and ability to follow directions Ability to work independently...MedicalHourly payPart timeCasual workRemote workHome officeMonday to Friday3 days per week
$22.99 per hour
...with specialized experience in medical billing clearinghouses and... ...dedicated EDI/ERA Enrollment Specialist to join our operational support... ...and electronic claims setup. This fast-paced position... ...Generate, monitor, and follow up on EDI agreements to ensure...MedicalClaimsHourly payPermanent employmentContract workTemporary workWork experience placementShift work$54.3k - $56k
...together! About the Job: The Accounts Payable Sr. Specialist is responsible for several critical tasks related to... ...and their eligible family members) may enroll in the following types of insurance coverage: medical, dental, vision, legal, and accidental death and...MedicalTemporary workRemote work$35 - $45 per hour
...seeking Disaster Recovery Public Assistance Specialists to join our dedicated team. This... ...clients in delivering FEMA Public Assistance following a presidentially declared federal... ...employment status, AECOM benefits may include medical, dental, vision, life, AD&D, disability...MedicalHourly payLocal areaWorldwideRelocation packageFlexible hours- ...sanitation policies and requires excellent communication skills to follow recipes and plan menus. Ideal candidates will have at least... ...setting. The hospital also offers comprehensive benefits including medical, dental, vision, and education opportunities. #J-18808-Ljbffr...MedicalLocal area
- ...Senior Claims Adjuster At Gallagher, we help clients face risk with confidence because... ...to ensure that claims practices correctly follow standards and laws. Other duties as... ...your job level these benefits may improve: Medical/dental/vision plans, which start from day...MedicalClaimsLive outWork at officeLocal areaFlexible hours
- ...customer service to residents Coordinate with maintenance and follow up on work orders Keep the office, model units, and community... ...Comprehensive benefits incluing free dental & vision; plus available medical, life, STD, AD&D, and more 401K retirement plan with 4%...MedicalFull timeWork at officeMonday to Friday
- ...Account Manager based on Sales Agreement Manage claim entry and ensure disposition is provided to... ...offer: Insurance: Affordable plans for medical, dental, vision, and wellbeing on the first day of the month following your start date Employer-Paid dental with...MedicalClaimsBi-weekly payTemporary workWork at officeLocal areaFlexible hours
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Medical Claims Follow-Up & Appeals Specialist. Be the first to apply!
- claim examiner Louisville, KY
- claims assistant Louisville, KY
- medical insurance claims specialist Louisville, KY
- claim specialist Louisville, KY
- insurance claims processor Louisville, KY
- claims analyst Louisville, KY
- claims consultant Louisville, KY
- claims processor Louisville, KY
- remote medical claims processor Louisville, KY
- medical chart review Louisville, KY



