Medicare Appeals & Grievances Specialist
Direct Jobs
Direct Jobs is seeking a full-time Appeals and Grievance Analyst in Irving, TX. This role involves independently researching grievances and appeals to ensure compliance with Centers for Medicare and Medicaid Services standards, as well as addressing member complaints. Ideal candidates will have experience with managed care plans, excellent communication skills, and the ability to analyze data. Engage with diverse individuals to promote member satisfaction and operational effectiveness. #J-18808-Ljbffr
- ...classifying, researching and resolving member complaints (grievances and/or appeals) and communicating resolution to members or their authorized... ...standards and requirements established by the Centers for Medicare and Medicaid Services and TRICARE. Coordinates with...SuggestedFull timeContract work
$14.9 - $29.06 per hour
...requirements established by the Centers for Medicare and Medicaid Services (CMS).... ...Responsibilities Enters denials and requests for appeals into information system and prepares... ...prepares responses to member appeals and grievances. Elevates appropriate appeals to the...SuggestedHourly payWork experience placementWork at officeRemote workWeekend work$14.9 - $29.06 per hour
...looking for an entry-level support role in claims activities. The position involves resolving member and provider complaints, managing appeals, and ensuring compliance with relevant guidelines. Candidates should have at least one year of relevant experience, strong customer...SuggestedHourly payWork at office- ...A healthcare organization is seeking a Denials & Appeals Specialist in Dallas, TX. The role involves reviewing and resolving denied healthcare claims and preparing appeals to insurance companies. Candidates should have 3-5 years of related experience and a strong understanding...Suggested
- ...Provider Enrollment Specialist- Medicare/Medicaid 3 years Payor (insurance company) enrollment experience Job description: Coordinates Medicare... ...regarding the processing of outstanding claims and/or appeals • Generates various reports to identify outstanding claims issues...Suggested
$55k - $65k
...accommodation or an alternative application process. Denials & Appeals Specialist Full Time Dallas, TX, US 6 days ago Requisition ID: 1259... ...denied insurance claims across all payer types (Medicaid, MCO’s, Medicare, Commercial etc.) Perform detailed denial analysis to...Full timeTemporary workLocal areaMonday to Friday- ...Southwestern Medical Center is looking for a Technical Denials Management Specialist II within its Revenue Cycle Department. This role focuses on reviewing, researching, and resolving claim denials and appeals across various insurance companies. A successful candidate should...Remote job
- ...Company : SimplyHome Job Title : Community Specialist Department : Community Asset Management (CAM) Reports to : Community Asset... ...and corresponding with residents and trades for optimal visual appeal of multiple communities. This role will report directly to the...Hourly payFull timeContract workWork at officeWork from home
- ...POSITION RESPONSIBILITIES: This position is responsible for all AR follow up including denials, reconsiderations, and appeals Accurate data entry of information into the computer system Provide reimbursement assistance to patients while providing...Work experience placementRemote work
$23 - $25 per hour
...Provider Enrollment Specialist Hornet Staffing, Inc. (a GEE Group company) - Irving,... ...Description & Responsibilities : Coordinates Medicare and Medicaid enrollment/re-enrollment... ...processing of outstanding claims and/or appeals Collects and reviews managed care...Hourly payWork at officeWeekend work- ...experienced Medical Accounts Receivable (AR) Specialist to join our healthcare billing team.... ...and via paper, as needed. Review and appeal denied or underpaid claims to maximize... ...with major insurance payers (Medicare, Medicaid, commercial). ~ Proficiency...Full timeWork at office
- ...of Work : 12 Days Of Week : 3 Work Shift : 12X3 Day (United States of America) Job Description : Job Purpose ~ The ECMO specialist participates in the development of a treatment plan, involving assessment, planning, implementation, and education. Communicates...Work experience placementShift work
- ...Provider Enrollment Specialist Shift: 8 AM - 5 PM Mon - Fri Duration: 13+ Weeks Notes... ..., EXCEL, ACCESS Summary: Coordinates Medicare and Medicaid enrollment/re-enrollment and... ...processing of outstanding claims and/or appeals Generates various reports to identify...Shift work
- ...Provider Enrollment Specialist Sigma Inc. is currently seeking a detail-oriented and experienced... ...Enrollment Specialist coordinates Medicare and Medicaid enrollment and re-... ...Monitor and follow up on outstanding claims, appeals, and accounts receivable Analyze reports...Work at office
$84.9k - $113.19k
Line of Business: Service & Support About Us Heidelberg Materials is one of the largest suppliers of building materials worldwide. In North America, the company operates more than 450 locations throughout the United States and Canada, employing approximately ...Temporary workRemote workWorldwideFlexible hoursNight shiftRotating shift$50.7k - $101.3k
...able to travel up to 30% Our Diagnostics business currently has an opportunity for the role of Associate Systems Integration Specialist for our Irving, TX location. The primary function of this position is to conduct research under the guidance of a research scientist...Work experience placementShift work- Data Architect / Data Modeling Consultant Location: Irving, TX, / Basking Ridge, NJ Work with cross functional teams that are part of the quote to cash process and leverage company data to help in the design, development, implementation and improvement of the quote...Work experience placement
$75.41k - $100.55k
Line of Business: Service & Support About Us: Heidelberg Materials is one of the world's largest suppliers of building materials. Heidelberg Materials North America operates over 450 locations across the U.S. and Canada with approximately 9,000 employees. ...Temporary workFlexible hoursShift workNight shift- Job Description About Us: Johnson Controls, a global leader in thermal management, mission-critical building systems, energy efficiency, and decarbonization, helps customers use energy more productively, reduce carbon emissions, and operate with the precision and...Contract workFor contractorsFor subcontractorLocal area
- Overview Texas Oncology is looking for an Admixture Technician to join our team!This position will support the Irving, Tx location. Hours are 8:30a-5:00p, Monday-Friday Texas Oncology is the largest community oncology provider in the country and has approximately 600+ ...Temporary workMonday to FridayShift work
- ...Nuclear Medicine Specialist - Heart & Vascular Specialist Clinic Bring your passion to Texas Health so we are Better + Together 26000256 **10,000 Sign-On for Eligible New Hires** Work location: 501 Rita Lane, Suite 101, Arlington, TX 76104 Work hours: Full-time, 40...Full timeMonday to Friday
- ...Associate Executive Specialist Wells Fargo is seeking Associate Executive Specialists, requiring mastery of complex administrative tasks, meticulous attention to detail, and the ability to manage multiple priorities in a fast-paced environment. Learn more about career...Work experience placementWork at officeRelocation package
- ...Irving, TX, US 15 days ago Requisition ID: 1195 The Medve Group, Inc. is actively seeking a Part-Time Bank Reconciliation Specialist. Ideal candidates will need to be able to demonstrate a stable relevant employment history. Responsibilities Complete monthly bank reconciliations...Part timeWork at officeRemote workFlexible hours
- A leading healthcare provider in Irving, Texas is seeking a Cardiovascular Tech RCIS responsible for assisting in invasive cardiovascular procedures, including monitoring and preparation of patients and equipment. Candidates should hold an Associate or Bachelor’s degree...
$64k - $87k
About HR Technology / People Analytics : Gartner's core asset is its people. Our people develop insights, share advice, and create experiences that help our clients be more successful. The People Analytics team within Gartner derives actionable insights from workforce...ApprenticeshipImmediate startWork from homeWorldwide- ...Delivery Specialist The Delivery Specialist will maintain and operate store vehicles to deliver parts and/or products to professional customers in a safe and efficient manner. This position will also collect money on C.O.D. deliveries and pick up customer returns....Local areaImmediate startRemote workFlexible hours
- ...Currently, we are seeking a Member Relationship Specialist who will assist new and potential members in identifying membership and lending needs and delivering solutions to their financial needs. Major Duties and Essential Functions To “deliver an unexpected experience...Work at office
- ...Aston Carter is looking for an Accounts Payable Specialist in Irving, TX. In this hybrid position, you will review and process high‑priority invoices and manage vendor payments through various channels. Strong customer service and attention to detail are essential. The...
- Advanced Hospice in Irving, Texas, is seeking a Marketing Manager to act as a liaison between the agency and the community. The role includes the development and promotion of home health programs while ensuring the agency meets its goals. The ideal candidate will achieve...
- ...HEDIS Specialist I Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has...Work at office
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