- Robert Half Finance & Accounting (Colorado Springs, CO)
- …identify payment discrepancies and patterns like downcoding or out-of-network adjustments by insurance companies. + Appeals and Denials: Manage insurance ... + Communication Tracking: Document all communications with patients and insurance companies, ensuring HIPAA compliance. + Reporting and Analysis: Generate… more
- Evolent (Denver, CO)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Specialty Appeals Team offers candidates the opportunity to make a meaningful impact as part of ... a highly trained dedicated team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and… more
- Cognizant (Denver, CO)
- …. Maintain working knowledge of applicable health insurers' internal claims, appeals , and retro-authorization as well as timely filing deadlines and processes. ... Medicare, Medicaid, and third-party guidelines. . Effectively document and log claims/ appeals information on relevant tracking systems . Utilize critical thinking… more
- CenterWell (Denver, CO)
- …our caring community and help us put health first** The Grievances & Appeals Representative 3 manages client denials and concerns by conducting a comprehensive ... with clinical and other Humana parties. The Grievances & Appeals Representative 3 performs advanced administrative/operational/customer support duties that require… more
- Lincoln Financial (Denver, CO)
- …for this opportunity. **Requisition #:** 74565 **The Role at a Glance** As an Appeals Specialist you will be responsible for being a product subject matter expert to ... for multiple product lines. You will perform and deliver on appeals claims assignments/projects while simultaneously leveraging and applying knowledge. You will… more
- Evolent (Denver, CO)
- …the mission. Stay for the culture. **What You'll Be Doing:** The **Coordinator, Appeals and Grievances** at Evolent is responsible for reviewing and processing case ... rather than phone and fax activities. **Collaboration Opportunities** : The Specialty Appeals Team offers candidates the opportunity to make a meaningful impact as… more
- Elevance Health (Denver, CO)
- **Behavioral Health Medical Director-Psychiatrist Appeals ** **Location:** This role enables associates to work virtually full-time, with the exception of required ... Saturday rotation, once a month.** The **Behavioral Health Medical Director-Psychiatrist Appeals ** is responsible for the administration of behavioral health medical… more
- Humana (Denver, CO)
- …Medical Director relies on medical background and reviews health claims and preservice appeals . The Corporate Medical Director works on problems of diverse scope and ... + Medical utilization management experience, + working with health insurance organizations, hospitals and other healthcare providers, patient interaction, etc.… more
- Humana (Denver, CO)
- …Director (CMD) relies on medical background to review health claims and preservice appeals . The Corporate Medical Director works on problems of diverse scope and ... + Medical utilization management experience + Working with health insurance organizations, hospitals and other healthcare providers, patient interaction, etc.… more
- Cardinal Health (Denver, CO)
- …queue as assigned in the appropriate system. + Manages and resolves complex insurance claims, including appeals and denials, to ensure timely and accurate ... right things done. **The Accounts Receivable Specialist is responsible for processing insurance claims and billing. They will work within the scope of… more