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
- ...Geisinger is seeking a dedicated professional to support the administration of the Appeals and Grievance process. The role involves acting as a liaison between members and the Plan regarding denied claims, services, and other concerns. Responsibilities include managing...SuggestedRemote work
- Summary of Position Responsible for processing expedited appeals: those that are complex in nature, require multiple hand-offs, and... ...requirements and turn‑around times of the Expedited Appeal unit, the Specialists are required to work weekends and holidays as the organization...SuggestedRemote jobHourly payContract workWeekend work
- Geisinger is looking for a professional to provide support in the administration of the Appeals and Grievance process. This role involves liaising between members and the plan to address denied claims and benefit issues. Applicants should have a minimum of 5 years of relevant...SuggestedRemote job
$58.9k - $80.07k
...The Appeals & Grievances (A&G) unit processes member and non-contracted provider appeals for all of HF's line of businesses which include... ..., dual enrollments, Medicare and complete care. Appeals Specialists are the subject matter experts responsible for non-clinical case...SuggestedTemporary workWork experience placement- Maximus is seeking a Senior Appeals Administrator for their California Independent Medical Review team. This role is vital in ensuring timely resolutions for medical review cases while enhancing the appeals process. The ideal candidate will have an associate degree with...SuggestedRemote jobWork from homeFlexible hours
- A healthcare solutions company is seeking an Appeals Coordinator to support the Appeals Department with administrative tasks and manage appeals and complaints. The ideal candidate will have 3+ years of healthcare experience, a strong background in claims processing, and...Remote job
- ...Billing Patient Financial Services at Corporate 42nd Street. You will analyze denied insurance claims, resolve denials, and coordinate appeals to help recover hospital revenue. Requirements include 3 years in hospital revenue cycle, strong Epic Resolute knowledge, and...
$50k - $55k
...Cost Outlier and Readmission reviews. Under the direction of the Appeals Department leaders, the Appeals Coordinator level II team... ...daily administrative work within the department. The Appeals Specialist level II performs research, investigation, and analysis of appeals...Remote work- Healthfirst is seeking an Appeals & Grievances Specialist to handle non-clinical case development and resolve member and provider appeals across commercial, Medicaid, Medicare and dual enrollment. You will research issues, interpret regulations, prepare documented appeals...Remote work
- 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...Remote work
- Blue Cross Blue Shield of Arizona is seeking a skilled professional for a clinical role addressing provider appeals and grievances. This position demands expertise in managed care while ensuring compliance with privacy regulations. The ideal candidate will possess a relevant...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...
- Ventra Health Inc. is seeking a Certified Coding Denials Specialist to work remotely in a full-time role. The specialist will manage claim edits and rejection work queues, ensuring timely investigation and resolution of health plan denials while adhering to departmental...Remote jobFull time
$58.5k - $69.97k
Position Summary We have an exciting opportunity to join our team as a Data Analyst, Financial Data Governance and Quality. The successful candidate reports to the Assistant Manager, Financial Data Governance and Quality and will maintain and analyze data within PeopleSoft...Work experience placement- Kids for the Future is looking for a Reimbursement Specialist who will be responsible for resolving insurance claims and ensuring timely reimbursements. The position is remote and requires in-depth knowledge of billing practices and strong communication skills. Candidates...Remote job
$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...Hourly payTemporary workInterim roleRemote workFlexible hours- Job Overview A law firm seeks a Supreme Court and Appellate Associate specializing in patent appeals and intellectual property in New York City, NY. The ideal candidate will have a strong background in handling complex technical subject matter across high-tech and life-...Temporary workFlexible hours
- Sagility is seeking an Appeals and Grievance Coordinator who will manage and resolve member and provider complaints while adhering to regulatory requirements. This role involves conducting investigations, documenting actions, and ensuring compliance. As a key contact for...Remote jobWork from home
$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- ...this mission, the BXDA seeks experienced and enthusiastic TPA Supervisor to assist with post-conviction litigation, including direct appeals, motion responses, and federal writs of habeas corpus. Responsibilities Draft motion responses and simple appellate briefs under...Work at officeFlexible hours
$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$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- ...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
$65k
...Yr. Max USD $68,000.00/Yr. Position Overview The Revenue Cycle Specialist reports to the Revenue Cycle Manager and will interface with... ...basis Reconcile claim denial reports on weekly basis, prepare appeals and implementation of programs to prevent future billing issues...Local area$390k - $425k
...The Department of Obstetrics & Gynecology is seeking a fulltime board certified or board eligible maternal fetal medicine specialist to support the department's outpatient faculty practices and the NewYork-Presbyterian Alexandra Cohen Hospital for Women and Newborns....Full timeWork at officeRelocation package$20.98 per hour
...Eligibility Specialist Department: FQHC Eligibility Assistance Employment Type: Full Time Location: Columbia - Broadway Bluffs Drive Compensation... ...other public health insurance options Assist patients with appeals and hearings related to MO HealthNet, CHIP and other public...Full time$23 - $25 per hour
...accessibility while raising the standard of care. As a Cash Application Specialist, you will be an essential part of the corporate business... ...missing claim information to ensure prompt payment Research, appeal and resolve claim rejections/denials with the appropriate Payor...Hourly payRemote work$21.38 - $44.4 per hour
...: $21.38-$44.40/hr (Dependent on Experience) The Revenue Cycle Specialist is responsible for billing and collecting from their assigned payor... ...resolve uncollected accounts and prepare charge corrections. Appeal carrier denials through review of coding, contracts, and...- ...diversity and inclusion for all employees. Day in the Life of an AR Specialist Perform all duties and responsibilities in accordance with... ...resolution to problematic accounts and payment discrepancies. Prepare appeal letters for technical denials by accessing specific payer...Contract workTemporary workWork at officeLocal areaRemote work
$75k - $105k
...exciting opportunity to join our team as a Senior Operational Specialist. In this role, the successful candidate will report to the Manager... ...Validate final outcomes (payment, adjustment, correction, or appeal resolution) prior to closure. Identify root causes of escalations...
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