- Molina Healthcare (Boise, ID)
- …subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines for ... able to rotate weekends and holidays** Must have Medicare Appeals and IRE experience** Responsible for reviewing and resolving... appeals and denials . + Strong verbal and written communication skills To… more
- R1 RCM (Boise, ID)
- …will help support clinicians who conduct a comprehensive review of clinical denials and formulate appeals based on clinical documentation, evidence-based medical ... patient care as well as conceptual knowledge of the denials landscape. Proficiency in basic computer skills is essential...**Here's what you will experience working as a Clinical Appeals Supervisor:** + Track and monitor the workflow of… more
- R1 RCM (Boise, ID)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our Denials & AR Analyst I, you will help R1 clients by analyzing ... craft appeal letters to resolve any insurance company medical denials . To thrive in this role, you must excel...to learn the status of previously resubmitted claims, written appeals , or updates on incoming claims payments. + Utilizing… more
- Cardinal Health (Boise, ID)
- …in the appropriate system. + Manages and resolves complex insurance claims, including appeals and denials , to ensure timely and accurate reimbursement. + ... Processes denials & rejections for re-submission (billing) in accordance with...changes that may need to be made. + Processes denials & rejections for re-submission (billing) in accordance with… more
- Trinity Health (Nampa, ID)
- …needed and requested by third party payers and Medicaid. + Responsible for appeals , denials , as appropriate. Utilizes physician advisor referral as appropriate. ... + Will adhere to department established process in reviewing 30 day re-admissions. + Follows established patient choice policy. + Documents assessment of primary and back up plans along with communications to patient , family and care team. + Participates in… more
- Intermountain Health (Boise, ID)
- …all pertinent patient related insurance eligibility, benefits, authorization; follow-up on appeals and denials when requested + Contacts patient/provider when ... insurance eligibility, securing prior authorization and managing authorization related denials to ensure patient financial health. **Essential Functions** +… more
- Molina Healthcare (Boise, ID)
- …by the Centers for Medicare and Medicaid. **KNOWLEDGE/SKILLS/ABILITIES** + Enters denials and requests for appeal into information system and prepares documentation ... systems and other available resources. + Assures timeliness and appropriateness of appeals according to state and federal and Molina Healthcare guidelines. +… more
- Surgery Care Affiliates (Boise, ID)
- …Effectively and independently handles second level reimbursement issues, contracted and non-contracted denials for serviced before and after procedures. + Works all ... denials and corrected claims collaborating with the biller and/or...HAVE knowledge of medical billing, payer follow-up, payer contracts, appeals , self-pay billing, Medicare and Medicaid billing, AR posting,… more
- Intermountain Health (Boise, ID)
- …levels, providers, clinical staff, compliance and the CDI team. + Audits and creates appeals for all payer and regulatory denials and downgrades and provides ... in-depth coding review, audit findings, and appeal strategies. + Develops and implements training plans for all internal stakeholders including coders at all levels, providers, clinical staff, compliance and the CDI team. + Audits clinical documentation and… more
- Adecco US, Inc. (Twin Falls, ID)
- …case outcome, follow-up or consultation such as prior authorization requirements, appeals , etc. . Educate members / guardians, providers, pharmacy staff on ... providers and apply benefit plan criteria in making decisions (approvals / denials ) or recommendations; clarify and explain pharmaceutical benefits and procedures. .… more
Recent Searches
- Physician Associate Urgent Care (Oregon)
- List Kitchen Responsibilities (United States)
- Studio Supervisor (United States)
Recent Jobs
-
Account/Sales Manager - Fire Alarm Systems
- Continental Fire Sprinkler Company (Omaha, NE)
-
Manager, Fresh Operations and Execution - Deli
- SpartanNash (Byron Center, MI)
-
Environmental, Safety, and Health Wage Agency Instructor
- Texas A&M University System (San Antonio, TX)
-
Nurse Practitioner or Physician Associate
- Provider Solutions & Development (Portland, OR)