Average salary: $72,658 /yearly
More statsSearch Results: 144,481 vacancies
Summary
SUMMARY: Coordinates and executes the appeal process for all AHS facilities clinical appeals and third party audits.
DUTIES & ESSENTIAL JOB FUNCTIONS: NOTE: The following are the duties performed by employees in this classification. However, employees may perform...
Suggested
Full time
...spent on the particular responsibility - High to Low
1.
Manages workflow for Humana PPI Audits, RAC Audits, or Outpatient Appeals and communicates daily with Sr. Director/Manager on trends identified
2.
Responds to queries within 72hrs, appropriately documents...
Suggested
...responsible for clinical oversight of assigned grievance and
appeal cases. Utilizes clinical judgement in the assessment, solution... ...)
May serve as a backup to absent Grievance & Appeals Nurse Specialists
Attends meetings as needed including but not limited to Clinical...
Suggested
Permanent employment
Contract work
Immediate start
Remote job
...Job Description
Role : Appeals Project Specialist
Estimated Duration : 6+ months
Location: Phoenix, AZ (hybrid)
Position Description
Reviewing medical records and writing administrative reviews- looks at recommendations by doctors, learning Client rules...
Suggested
Remote job
...Senior Grievance and Appeals Specialist
VillageCare is looking for a self-motivated individual for a Full Time role as the Senior Grievance Specialist. This role is responsible for the investigation and resolution of all Medicare and Medicaid lines of business complaints...
Suggested
Holiday work
Full time
Work from home
...appropriate.
Provide correction suggestions to other departments so the invoice can be resubmitted.
Provide coding direction to appeal invoices and/or submit appeals via payer website or fax, as directed.
Complete reconsideration letters as needed.
Complete...
Suggested
Holiday work
Flexible hours
...Description
Job Description Our client is a busy Medical office located in Tarpon Springs. They are seeking a temporary Claims & Appeals Specialist to join their team. The ideal candidate will be able to prioritize tasks, multitask, and have high attention to detail....
Suggested
Temporary work
Local area
Monday to Friday
...Services has a reputation for excellent customer service in the marketplace, and this position is crucial to continuing that status.
Appeals may be submitted by providers and/or their representatives, members, attorneys, and sometimes a PPO (Preferred Provider...
Suggested
Hourly pay
Full time
Temporary work
Monday to Friday
...Appeals and Compliance Specialist
Starting Salary: $84,495 - $101,395
This position reports to the Executive Director and is responsible for managing complaints, informal resolution meetings, mediations, and appeals, ensuring compliance with state and federal laws...
Suggested
Holiday work
Full time
Contract work
Work experience placement
Flexible hours
...residents and to support the safety net required to achieve that purpose.
Job Summary
The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve member and provider complaints and appeals exercising strong independent...
Suggested
Local area
$24 - $26 per hour
...Job Title : CHS Appeals Specialist
Department : Revenue Cycle
Reports To : CHS Director, Denials
Job Summary : The CHS Appeals Specialist works as an integral part of the Revenue Cycle team. Responsible for the administration and coordination of the denial...
Suggested
Full time
...Work Shift:
Day (United States of America)
**The Denials Specialist role is eligible for a $1,500 sign on bonus.**
**This position... ...interpreting denials and facilitating first and second level appeals to insurance.
The ideal candidate will have experience with...
Suggested
Relocation bonus
Flexible hours
Shift work
Early shift
...states, Washington, D.C., Puerto Rico and the United Kingdom.
The Atlantic Region CBO is seeking a dynamic and talented Appeals Specialist.
The Appeals Specialist is responsible for the resolution of all appeals relating to technical issues identified during...
Suggested
...Responsible for tracking, appealing and resolving denied claims, as well as analyzing reimbursements according to contractual agreements. Performs a variety of duties including accounts receivable follow-up, customer service, correspondence response and daily reconciliation...
Suggested
Full time
Temporary work
Local area
...Job Description
Division/Unit: Appeals Division
Position Title: Appeals Paralegal
Civil Service Title: Community Associate
Salary Range: $49,000 - $51,984
Job Description:
The New York County District Attorney's Office anticipates openings beginning in...
Suggested
Summer work
Shift work
Monday to Friday
...environment!
In collaboration with the claims leadership and other internal and external stakeholders, the Claims Audit and Appeals Specialist will be accountable for managing second level provider disputes, the review and resolution of claims related issues, and...
Holiday work
Remote job
Monday to Friday
$40.87 - $67.82 per hour
...prioritizes its employees, explore our current job opportunities below.
Job Summary: The Grievance Resolution Specialist coordinates the Grievance and Appeal resolution process, responds to verbal and written Grievances and Appeals from members and/or providers...
Weekly pay
Full time
Contract work
Flexible hours
Weekend work
Afternoon shift
$28.38 - $31.93 per hour
...Grievance and Appeals Specialist
VillageCareMAX
112 Charles Street, New York, NY 10014
VillageCare is looking for a self-motivated individual for a Full Time role as the Grievance & Appeals Specialist. This position ensures that grievances and appeals are resolved...
Holiday work
Full time
Work experience placement
Work from home
...States, Washington, D.C., Puerto Rico and the United Kingdom.
The Atlantic Region CBO is seeking a dynamic and talented Appeals Specialist.
The Appeals Specialist is responsible for the resolution of all appeals relating to technical issues identified during...
Local area
Overview:
The Claim Appeals Specialist is responsible for researching and addressing claim issues related to medical necessity in which a request for additional information or denial of payment has been received. This position works closely with payers and our Billing...
Full time
Work experience placement
