Appeals Specialist
World Travel & Connect
Medical Data Systems Inc. is seeking a detail-oriented and motivated Insurance Specialist to join our insurance support and billing team. The ideal candidate will demonstrate professionalism, independence, and a strong understanding of insurance processes while thriving in a fast-paced environment. Key Responsibilities Perform insurance follow-up activities, including claim submission, claim status inquiries, and filing appeals for denied claims Process a high volume of detailed account information accurately and within established performance guidelines Navigate multiple systems to obtain insurance, contact, and attorney information as needed Support the prioritization of collections efforts by accurately updating account data and identifying next steps Maintain the highest level of confidentiality and adhere to all HIPAA regulations Apply hospital billing knowledge to carry out assigned duties efficiently Essential Duties Complete insurance-related tasks such as correcting and resubmitting claims, filing appeals, and contacting insurance companies, attorneys, or patients regarding outstanding balances Work assigned facility-specific queues, ensuring all accounts are updated with correct and complete information Participate in special projects or assignments as directed Assist colleagues and management by providing information or support related to insurance processes when needed Qualifications 3-5 years of experience in a healthcare setting such as a hospital business office, surgery center, physician practice, or health insurance organization Strong communication skills, attention to detail, and self-motivation Proficient knowledge of insurance processes, including claim submission, claim denials, HCPCS/CPT/ICD-10 coding basics, and claim status inquiries Familiarity with Medicare/Medicaid, Commercial, Auto, Workers’ Compensation, Liability, Crime Victims, and State/Federal Insurance Programs Experience with medical billing and collection practices, business office procedures, and multi‑system computer navigation Ability to type at least 55 words per minute High School Diploma or GED required; some college preferred Position Details Employment Type: Full‑Time #J-18808-Ljbffr World Travel & Connect
- ...St. Luke's in the United States is seeking a Denials Management Specialist to join our remote team. This role focuses on inpatient CMS denials, medical necessity reviews, and appeals for insurance payers. You will collaborate with Case Management and Billing to improve...SuggestedRemote work
- MJHS seeks an A&G Specialist in New York, NY to handle department correspondence, log and route mail, and provide back-up support to coordinators... .... The role emphasizes timely processing of grievances and appeals within regulatory timeframes. Responsibilities include opening...Suggested
- Build the career you want and make a powerful impact.NursingAs a professional and skilled home care nurse with VNS Health, you will flourish in an environment which encourages growth and provides opportunities to advance your nursing career. While using your expertise to...SuggestedLive in
- A healthcare service provider is seeking an Appeals and Grievances Clinical Specialist to manage member complaints and clinical case resolutions. This is a 100% remote role requiring an RN, LPN, or Dental Hygienist license. Responsibilities include developing cases, researching...SuggestedRemote work
- ...claims end-to-end, from portal follow-ups and payor calls to appeals and medical records, so providers can resolve more denials, recover... ...the Role We're looking for a Senior Accounts Receivable Specialist to join our client onboarding team — a small group of...SuggestedPermanent employmentFull timeWork at officeImmediate startFlexible hours
$50k
...are a leading authority in payment integrity solutions including DRG Validation, Cost Outlier and Readmission reviews. The Appeals Specialist I is responsible for performing triage, review, analysis, and resolution of facility-submitted appeals, involving non-...Full timeContract workWork experience placementRemote work- Alaffia is seeking a Clinical Itemized Bill Reviewer to join our Appeals and Disputes team. You will review disputes tied to Payment Integrity findings, focusing on high-dollar facility claims and itemized bills, using clinical, coding, and auditing expertise. Ideal candidates...Remote job
- Prism Vision Group is seeking a Revenue Cycle Specialist located at Spokane Eye Clinic, Spokane, WA. This role involves handling billing and collecting from assigned payors, ensuring compliance with regulations and customer service excellence. Candidates should possess...
$22 - $23 per hour
Immediate need for a Grievance & Appeals Coordinator . This is a 12+ Month Contract opportunity with long-term potential and is US ( Remote ). Please review the job description below and contact me ASAP if you are interested. Job Diva ID: 26-07046 Pay Range: $22.00 -...Contract workWork at officeLocal areaImmediate startRemote work- ...to-Know Law and Sunshine Act to the public. It offers growth in research and writing in a government setting. The position supports appeals, with duties including analysis of statutes, writing summaries, and assisting attorneys. #J-18808-Ljbffr Commonwealth of...Work at office
- ...care continuum. For more information, visit . Job Title: RCM Specialist-Ophthalmology Must reside in the following states : AL, AZ, FL,... ...responsibility to forward to the collection team •Ability to research and appeal denied claims •Answering all patient or insurance telephone...Work at officeRemote workHome officeFlexible hoursAfternoon shiftEarly shift
$60k - $80k
...in lots; and execute bids at sale. Collaborate with marketing, editorial, and specialists to develop content or programming that highlights the continued relevance of antiques and appeals to next generation collectors. Working with the Furniture, Silver and European...Work at officeLocal area$34 - $38 per hour
...client data for completeness and accuracy of coding, using clinical knowledge to ensure proper reimbursement and respond to provider appeals. This is a remote, shift-based role across MT and ET time zones with after-training rotating weekends and holidays; training lasts...Remote jobHourly payShift work$28.85 - $35 per hour
...engaged to conduct a search for a Denials & Revenue Recovery Specialist for a fast-growing healthcare revenue recovery organization .... ...specific workflows. You will manage assigned denial queues, submit appeals, and follow claims through to final resolution while...Remote jobHourly payTemporary workInterim roleFlexible hours- ...Medical Billing is hiring for a remote Revenue Recovery Associate to aggressively follow up on outstanding claims, resolve denials, and appeal claims for additional payment. This contract role focuses on AR management, accuracy, and revenue optimization for clients...Remote jobContract work
$10 per hour
...Professional Coder (CPC) to manage denial issues and ensure accurate medical billing. The ideal candidate will analyze denials, manage appeals, and ensure compliance with coding guidelines. Applicants should have a CPC certification and a strong coding background. This full...Remote jobFull time$45k
...Yr. Position Overview # SCOPE OF ROLE : The Housing Specialist supports SSVF program participants with their search for appropriate... ...rents and lease terms (when possible) with landlords. Appeal tenant selection decisions. Conduct and document housing...Permanent employmentTemporary workLocal areaRemote workWork from home$80 per hour
...commercial, Medicare Advantage, Medicaid, and other payer authorization requirementsAssess authorization status tracking, denial outcomes, appeal pathways, escalation processes, and turnaround time expectationsEvaluate prior authorization workflows across multiple specialties,...Hourly payPart timeFor contractorsWork at officeRemote workFlexible hours$75k - $105k
...exciting opportunity to join our team as a Senior Operational Specialist. In this role, the successful candidate reporting to the Manager... ...resolution Validate final outcomes (payment, adjustment, correction, or appeal resolution) prior to closure Advanced Issue Investigation &...- CrewBloom seeks a detail-oriented medical billing assistant to help prepare and submit appeals, review EOBs, and ensure accurate CPT/ICD coding under guidance. The role supports workers’ compensation claim processing and a broad range of billing tasks. This position favors...Remote jobHome office
$50k
...treatment team to gather necessary information for concurrent reviews Schedule peer-to-peer reviews and coordinate urgent/expedited appeals Staff individual cases with medical doctors as required Maintain compliance with all standard utilization review policies and...Remote work- ...Prior Authorization Specialist Full-Time | On-Site | Ashland, PA About the Role Concept Billing Solutions is seeking a detail-oriented... ...authorizations and monitor requests through resolution. Coordinate appeals and additional documentation when authorization requests are...Full timeWork at office
$56.2k - $101k
...or work experience providing equivalent background required. Minimum of two years experience in medical claims review and/or claims appeal required. Preferred Qualifications: Candidates with strong claims analysis experience. Experience with independent dispute...Full timeContract workPart timeWork experience placementH1bWork at officeRemote workWork from homeFlexible hours$28 - $32 per hour
...Description Job Title: Database Specialist Reports to : Vice President of Philanthropy FLSA Status : Hourly/Part-Time - Non-Exempt ---... ...Give/Get reports, Annual Report donor listing, mailing lists for appeals, and other Raiser's Edge reports as requested. Reconcile donor...Hourly payPart timeWork at office- ...Coronis Health is seeking a remote Utilization Review Specialist to manage treatment authorization for behavioral health and substance... ...entities. The role covers pre-certification, concurrent reviews, and appeals with a focus on compliance and patient privacy. The position...Remote work
$72k - $85k
...Administration Hours Per Week: 35 Position Summary The Coding Specialist III is responsible for the review and resolution of all coding... ...insurance companies and clinicians to resolve issue. Manages appeals with insurance companies for surgical claim reimbursement when...Local area$77.29k - $94.21k
Job Description - Sr Revenue Cycle Specialist (2602625) Sr Revenue Cycle Specialist At Stony Brook Medicine, the Senior Revenue Cycle Specialist... ...regarding Managed Care Contracts, CM System and Denials and Appeals process. Assist in maintaining and creating payer report cards...Full timeContract workShift workDay shift- Reference: 627714Posted: 2026-06-11Location: Manhattan, New YorkCompany: Planet Pharma GroupContact: ApplicationsEmail: ****@*****.*** Functions: * Gains and consistently increases product knowledge through formal sales training; physician speaker...Local areaRemote workNight shift
$22 per hour
...in the medical alarm industry, seeking a seasoned Revenue Cycle Specialist with health insurance claims experience to fill a role in the... ...reimbursement within established payer timelines. Review, analyze, and appeal denied or underpaid claims in accordance with payer policies...Hourly payPermanent employmentFull timeTemporary workWork at officeRemote work- ...United States is seeking a Senior Manager, Pricing to lead a team of professionals and contractors in managing pharmacy reimbursement appeals, including the Service Warranty process, and to support state insurance regulators and secondary appeals operations. You will...For contractors
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