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
- ...Judi Health in New York, NY seeks a subject-matter expert in prior authorization and appeals to oversee operations across multiple lines of business. This role manages a team of appeals pharmacists and staff, ensuring compliance and high quality of care. The position requires...SuggestedFlexible hours
- ...NoctrixHealth is seeking a Patient Access Appeals Case Manager in the United States to support patients and providers through denial and appeal processes for our DME device. You will collaborate with payers and health plans to secure coverage and drive streamlined access...Suggested
- 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
- 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 job
$22 per hour
Broadway Ventures, a United States-based firm, is seeking candidates for a temporary 6-month role that is 100% remote. Compensation is $22 per hour with training provided. Responsibilities include prioritizing workload, using OnBase and MAS to record and upload documents...SuggestedRemote jobHourly payTemporary work$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- ...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...Permanent 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$140k - $160k
...professional looking for a long-term fit where you can grow in a role, and will be valued and empowered, then we invite you to apply to our Appeals and Complex Motions Associate Attorney position in our New York, New York Office.This position offers a flexible, hybrid working...Full timeWork at officeFlexible hours- ...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
$22 - $23 per hour
A leading healthcare consulting firm is seeking a Grievance & Appeals Coordinator for a remote position. This role involves processing and resolving member appeals and grievances while maintaining compliance with healthcare regulations and quality standards. Candidates...Remote jobContract work$24.05 - $36.21 per hour
...mission at MSK and around the globe.Exciting Opportunity at MSK: Specialist I, Insurance Receivable At MSK, the Specialist I, Insurance... ...payment delays, and outstanding balances. Prepare corrected claims, appeals, payment transfers, insurance refunds, recoding, and...Full timeWork at office- ...for career advancement.Job DescriptionBudget and Reimbursement Specialist OverviewThe Budget and Reimbursement Specialist will oversee... ...state officials on Medicaid/Medicare audits, rate reviews, and appeals processes.Manage the Certificate of Need process for capital projects...
$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 - $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$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$21.68 - $31.08 per hour
...Knowledge, Skills, and Abilities Knowledge of dental and vision claims payment and billing processes Knowledge of general practices for appeals, complaints, and grievances handling Knowledge of federal and state regulations as it pertains to health care compliance Holds...Hourly payPermanent employmentSecond jobWork at officeRemote workWork from homeWeekend work$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- Science Friday is seeking a Membership Specialist to lead day-to-day membership operations, improve member experience, and grow the digital... ...and audience teams to optimize donor engagement, execute appeals, and monitor performance metrics. #J-18808-Ljbffr Science Friday...Remote job
$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- ...and processing of employee grievances and hospital discipline. Conducts hearings at the Corporate level, participates in arbitration appeals and maintains liaison with employee union representatives and personnel labor relations administrators of local hospitals. Performs...Contract workWork at officeLocal areaWork from home
$10k
...mission of the agency. Position Summary: The Labor Relations Specialist will play a critical role in developing and implementing a newly... ...: - Coordinate agency grievance review and disciplinary appeals proceedings and assist in the case preparation for Step 2 and...Permanent employmentWork at officeWork from home2 days per week- DaMar Staffing is seeking a Remote Medical Coder with CPC/CCS certification to review medical records for Medicare appeals. You will evaluate NCD/LCD denials, duplicate denials, and MUE denials, determining if conditions of coverage exist and providing uphold justifications...Remote job
- Healthfirst seeks a Manager of Clinical Appeals & Grievances to lead a fast-paced team and coordinate with organizational leaders to optimize processes and drive performance. The role oversees internal and external production and ensures high quality and compliance across...
- CVS Health in the United States is seeking a Senior Manager, Pricing to lead a team focused on pharmacy reimbursement appeals, including the Service Warranty process, ensuring adherence to tight Turnaround Times and state regulations. The role involves coaching the appeal...
- Jackson Lewis P.C. is seeking a Billing Appeals Manager to lead a 10-12 person team responsible for maximizing revenue recovery through billing appeals, audits, and reductions. The role requires deep expertise in legal billing, carrier guidelines, and audit strategies,...
$128k - $160k
...Supervisor, Appeals Pharmacist Charlotte, North Carolina, United States; Denver, Colorado, United States; New York, New York, United States About Judi Health Judi Health is a health technology company providing benefit administration solutions to employers, unions...Contract workWork at officeLocal areaRemote workMonday to FridayFlexible hoursShift workWeekend work$145k
...possibilities We Want to Talk to You! The Difference You Make: We are looking for an experienced PolyPath Market Risk Specialist with strong technical and business knowledge to support pricing, valuation, and market risk activities within a large banking or...Hourly payFull timeContract workWork experience placementShift work- ...(MTA) New York City Transit is seeking a Staff Analyst I/II or Associate Staff Analyst to administer ADA Access-A-Ride eligibility appeals. The role involves processing appeals, scheduling hearings, communicating with appellants, and generating periodic reports on suspension...Remote job
$90k - $140k
...London, Tokyo and Singapore, which manages Fixed Income portfolios for a broad range of clients. The RoleThe Fixed Income Portfolio Specialist will be responsible for servicing existing clients and driving commercialization of the institutional Global Multi-sector...Temporary workWork at officeWorldwide
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