• RN Clinical Review Appeals Specialist

    St. Luke's University Health Network (Allentown, PA)
    …The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all diagnosis and procedure codes to ... determination made by the government or commercial payors, or their auditor representative . + Facilitate clinical chart reviews to assist with supporting assigned… more
    St. Luke's University Health Network (07/08/25)
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  • Coding Appeals Specialist

    St. Luke's University Health Network (Allentown, PA)
    …health care. The Coding Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all diagnosis and procedure codes to ... AMA CPT, are assigned to support the services/treatment rendered. The Coding Appeals Specialist also prepares appeal arguments and/or letters to support and defend… more
    St. Luke's University Health Network (05/19/25)
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  • Tax Analyst - Audit and Appeals

    Penske (Reading, PA)
    …audits, including negotiating with auditors and interfacing with taxing jurisdictions. -Perfect appeals and refund claims . -The position will require the ability ... and efficiencies are met. -The ability to query, analyze data , and map detailed processes coupled with analytical skills...Requirements:** -The physical and mental demands described here are representative of those that must be met by an… more
    Penske (06/06/25)
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  • Sr. AR Collections Representative

    TEKsystems (Philadelphia, PA)
    …Reviewing claims with no response. Reviewing denied claims or underpaid claims and resolving the denial and filing appeals , as necessary. Ensuring all ... by handling a significant amount of manual work, including data entry and QA support to review billing information....could be assigned to hospital, professional, or home care claims . + Submits timely, accurate claims to… more
    TEKsystems (07/25/25)
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  • Collections Representative

    Owens & Minor (Harrisburg, PA)
    … representative follows-up with insurance companies to resolve unpaid claims . **ESSENTIAL DUTIES AND RESPONSIBILITIES** + Researches any overdue account balance ... customers on delinquent payments. + Reviews unpaid and underpaid claims . Resubmits or appeals as necessary. +...a strong ability to understand, interpret and develop spreadsheet data . **Other Skills** **PHYSICAL DEMANDS** This is a stationary… more
    Owens & Minor (07/27/25)
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  • Sr. AR Collections Representative

    TEKsystems (Philadelphia, PA)
    …Reviewing claims with no response. Reviewing denied claims or underpaid claims and resolving the denial and filing appeals , as necessary. Ensuring all ... could be assigned to hospital, professional or home care claims . -Submits timely, accurate claims to insurance...and escalation to management team as deemed necessary. -Reviewing data sets CPT-codes, IDC-10 codes, HCPCS codes, coordination of… more
    TEKsystems (07/25/25)
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  • Benefits Operations Specialist

    Guardian Life (Bethlehem, PA)
    …and key resource for day-to-day tier 3 escalations related to eligibility, enrollment, and claims . This includes but is not limited to: + Overseeing the Field ... Representative billing process and collaborating with internal stakeholders and...(BAC), reviewing, researching, presenting, and responding to administrative plan appeals . + Processing all health, welfare, and wellness vendor… more
    Guardian Life (06/20/25)
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