Responsible for leading, organizing and directing the activities of the Grievance and Appeals Unit that is responsible for reviewing and resolving member complaints and communicating resolution to members or authorized representatives in accordance...
POSITION : Clinical Appeal Analyst
DEPARTMENT : Denials
REPORTS TO: Clinical Denial Supervisor
Investigate new business accounts utilizing all resources available, and document findings in necessary systems.
The ideal candidate possesses the below qualifications:
~2+ years of experience with Hospital Coding/Billing/Collections/Appeals
~ Experience with both Medicare Recovery Audits & Managed Care Audit processes
~ Knowledge of medical claims
...work you do truly makes a difference in people’s lives every day?
West’s Health Advocate Solutions is currently seeking an Appeals Specialist for our site in Plymouth Meeting, PA. Our next Appeals Specialist should have a great eye for detail, possess strong...
- High School Diploma or GED
- Word Processing
- Communication Skills
- Microsoft Word
- Customer Service
- Microsoft Office
Performs non-medical reviews and processes redetermination letters.
50% Performs non-medical...
A financial services company has an open position for a Remote Appeals Specialist.Core Responsibilities of this position include: Evaluating the denied claim and the claimant’s letter of appealObtaining whatever additional information is needed in order to fully evaluate...
...Prepares Reconsideration (first level of the disputed claims process for FEP members as defined by the FEP Contract, i.e. level one appeal) files and initiates request(s) for all necessary documentation from all identified and applicable providers/sources, in order to...
...A-Line Staffing Solutions is looking to hire several Grievance and Appeals Specialists in Tempe, AZ, full details below:
Pay:$21 per hour (based on experience)
City/Zip Code: Tempe, AZ - 85282
Various 8 hour shifts available Monday - Friday: between 8AM -...
The function of the Appeals/Collection Specialist is to collect unpaid claims, responsibilities include appealing denials, collections of underpayments, and documenting collection activity in the billing system.
Position: Appeals & Grievances Specialist
Location: Harrisburg, PA 17110
Duration: 6 months temp to perm | 40hr/week | M-F
Pay Rate: $18-$20/hr. on W2
This is an entry level position in the NGS Appeals Department...
...Customer Service and researches Practice Connect issues for resolution. Responds to provider calls related to provider disputes and appeals for incoming provider / member disputes
Identify, trend, and report the Provider Dispute and Resolution process for Monarch...
Ear, Nose & Throat Specialists of Northern Virginia
Ear, Nose & Throat Specialists of Northern Virginia is currently seeking an Insurance Medical Appeals Billing Specialists to join our team. The main responsibility is to manage and work the outstanding A/R for "all" major carriers.
...WellCare has an exciting opportunity for an Appeals Coordinator position for our Detroit, Michigan office.
Processes appeals from receipt to resolution in a timely and accurate manner.
Reports to: Mgr. Appeals
...will provide you the tools and
resources you need to succeed in our organization. We are currently looking for
an ambitious Clinical Appeals Nurse to help us reach our goals. Unlock your potential
As a Clinical Appeals Nurse, you will be responsible for handling...
...We Are Hiring
Appeals Denial Specialist - RN- Revenue Cycle Mgmt - Full-Time,Day - Ascension Michigan
Location: Cooperate Service Building (CSB) Warren, MI
Why Join Ascension?
In Michigan, Ascension operates 16 hospitals and hundreds of related healthcare...
A-Line Staffing is actively searching for Multiple Accounts Receivable reps, for a major healthcare company located in Phoenix, AZ. This is an exciting opportunity with a client that is looking to move fast for the right candidate. Please contact Brad Zidek at [Click...
This individual must be an PT, OT or SLP who will work remotely supporting the appeals process.
Assists the Genesis denial management team by conducting a comprehensive analytical review of patient's medical records. Appeal Writer/ Reimbursement...