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$48.08 - $57.69 per hour
...an existing Fisher Phillips office)Fisher Phillips, a premier international labor and employment law firm, is seeking an Insurance Appeals Specialist to join our Legal Project Management Team. This role is responsible for managing, researching, interpreting, and drafting...SuggestedHourly payFull timeWork at officeRemote workRelocation- ...by the Centers for Medicare and Medicaid Services (CMS).Essential Job Duties• Facilitates comprehensive research and resolution of appeals, disputes, grievances, and/or complaints from Molina members, providers, and related outside agencies to ensure that internal and/or...SuggestedContract workWork at office
$191.5k - $355.6k
At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.Join HCSC and be part of a purpose-driven company that will invest...SuggestedFull timeWork at officeRemote workWork from home$248.5k - $373k
...the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.Primary Responsibilities:The Appeals and Grievances Medical Director is responsible for ongoing clinical review and adjudication of appeals and grievances cases for UnitedHealthcare...SuggestedMinimum wageWork experience placementLocal areaRemote work$94.2k - $129.5k
...visit guardanthealth.com and follow the company on LinkedIn, X (Twitter) and Facebook. Position SummaryThe Supervisor, Revenue Cycle - Appeals and Claims Follow-Up is responsible for leading the day-to-day operations and performance of the Appeals and Claims Follow-Up team....SuggestedFull timeWork at officeRemote workWork from home$248.5k - $373k
...responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing togetherWork at home!The Appeals and Grievances Medical Director is responsible for ongoing clinical review and adjudication of appeals and grievances cases for...SuggestedMinimum wageWork experience placementLocal areaRemote work- ...Job Title Job Description Process appeals and grievances, analyze, research, and provide comprehensive responses in accordance with established regulatory and accreditation guidelines. Contact customers to gather information and communicate disposition of case...SuggestedContract workApprenticeshipLocal areaRemote work
- ...Appeals Clerk Job Title: Appeals Clerk Duration: 3+ months contract Location: Milwaukee, Wisconsin 53224 Shift: 8:00AM to 5:00PM Need strong data entry abilities, healthcare experience and attention to details Will take information and transfer appeals documentation...SuggestedContract workWork at officeShift work
- ...Auditing experience with DRGs. Responds to commercial payers, managed care and third party review organizations in managing the appeals/denials process. Supports the review of denial trends and identifies coding issues and knowledge gaps. Job Responsibility Supports...SuggestedHourly pay
- APPEALS SPECIALIST Do you like challenging payers? That feeling of satisfaction when your appeal is overturned? Then, this position may be right for you! CAF is in search of an experienced Appeals Specialist who is well versed in challenging insurance denials, utilizing...SuggestedFull timeContract work
- ...Atlantic Region CBO Appeals Specialist The Atlantic Region CBO provides business office services including billing, collections, cash posting, pre-access management, variance, and customer service to our affiliated Universal Health Services hospitals. The Atlantic Region...SuggestedWork at officeLocal area
- ...Appeals Coordinator Responsible for clinically assessing all adverse determinations made by insurers through all levels of the appeals process. Education Other Graduate of an accredited school of nursing Required Experience General Experience and knowledge of InterQual...Suggested
- ...denied claims by identifying reasons for denial or dispute and collaborating closely with Nurse Auditors to support medical necessity appeals. This position requires preparing and submitting accurate appeal documentation, conducting thorough research to gather supporting...SuggestedWork at officeLocal area
- ...today to see how a conversation can turn into a long-lasting and rewarding career! Job Description Are you an experienced Medical Appeals Specialist in the Tacoma, WA area seeking a great career opportunity? Have you recently been seeking out prestigious, national healthcare...SuggestedHourly payContract workPrivate practice
- Job SummaryThe Appeals Specialist is responsible for reviewing insurance denials and preparing comprehensive appeal submissions for behavioral health, substance use disorder, primary care, and ancillary services. This position serves as a liaison between clinical staff,...SuggestedWork at office
- Job Overview OrthoMed Anesthesia, located in Addison, TX, is seeking a detail-oriented Appeals Specialist. The role is full-time and requires on-site presence during regular business hours at our corporate office. Key Responsibilities Review denied claims and determine...Full timeWork at office
$54.1k - $142.58k
...CVS Health Nurse Appeal Consultant We're building a world of health around every individual shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose...Full timeLocal areaRemote workShift workWeekend work- ...Appeals Intake Coordinator The Appeals intake coordinator position is focused on the processing of incoming member and provider Medicare appeals and grievances. This team member will screen incoming complaints and appeals for level of urgency, benefit or medical necessity...
- ...Clinical Appeals Nurse The Clinical Appeals Nurse is responsible for investigating and processing medical necessity appeals from members and providers to payers. Possesses the ability to conduct research on standards or practice, regulations, and policy relevant to...
- ...Grievance And Appeals Analyst I The Grievance and Appeals Analyst I is responsible for the review, investigation, and resolution of member grievances and appeals within a managed-care health plan. Ensures all activities are conducted in compliance with regulatory requirements...Full timeContract workWork at office
- ...Nurse Appeals Associate Nurse Appeals Associate Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports...Full timeTemporary workLocal area1 day per week
- ...Clinical Appeals Coordinator, RN The Clinical Appeals Coordinator, RN is responsible for supporting the end-to-end processing of clinical appeals, including medical necessity, benefit, pharmacy, behavioral health, and administrative appeal issues, as applicable. This...Work at office
$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$22 per hour
We are seeking an Appeals & Grievances Coordinator to join The Hollister Group, a leading women-owned staffing firm in the Boston area. This role is remote with a compensation of $22/hr . Responsibilities: Coordinate appeals and grievances activities Track all member appeals...Contract workRemote work$11 - $13 per hour
...Toll Free: (***) ***-**** Facebook page opens in new window YouTube page opens in new window Linkedin page opens in new window The Appeals department is the backend for when an insurance hasn’t paid a medical claim correctly, or hasn’t been processed correctly based on...Contract workWork at office- ...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...Full timeWork at office
- ...Middleburg Heights 1 7500 Old Oak Blvd Middleburg Heights, OH 44130, USA Overview: Respond to all assigned levels of denials by submitting appeal letters and required documentation to insurance companies within the appeal filing time limits. Submit external review requests and...Remote work
- ...Appeals and Grievance Specialist II (Managed Care) Irving, TX | 12-Week Contract Location: Irving, TX Job Type: 12-Week Contract Company: Sigma Inc. Schedule: MondayFriday | 8-Hour Shifts Join Our Team as an Appeals and Grievance Specialist II! Sigma Inc. is seeking...Contract workShift work
- ...Appeals Coordinator 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...Contract workWork at officeMonday to Friday
- ...Coding Appeals Specialist St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which...