- Molina Healthcare (FL)
- …appropriate appeals and grievance outcomes. * Requests and reviews medical records, notes, and/or detailed bills as appropriate; formulates conclusions per ... subrogation and eligibility criteria. * Experience with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines for… more
- Molina Healthcare (Tampa, FL)
- …subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines for ... determine appeal and grievance outcomes. + Requests and reviews medical records, notes, and/or detailed bills as appropriate; formulates... appeals and denials . + Strong verbal and written communication skills To… more
- Molina Healthcare (Miami, FL)
- …subrogation and eligibility criteria. * Experience with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines for ... Surprise Act** cases outcomes. . * Requests and reviews medical records, notes, and/or detailed bills as appropriate; formulates... appeals and denials . * Customer service experience. * Strong organizational and… more
- Molina Healthcare (FL)
- …Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Enters denials and requests for appeals into information system and prepares ... systems and other available resources. * Assures timeliness and appropriateness of appeals according to state, federal and Molina guidelines. * Requests and obtains… more
- HCA Healthcare (Ocala, FL)
- …We want your knowledge and expertise! **Job Summary and Qualifications** The Clinical Denials Coding Review Specialist is responsible for applying correct coding ... experience preferred, such as accounts receivable follow-up, insurance follow-up and appeals , insurance posting, professional medical /billing, medical … more
- United Therapeutics (Melbourne, FL)
- …information + Able to effectively handle questions pertaining to prior authorizations, denials and appeals + Essential telephone and electronic communication ... which transplant is not currently an option. The Access & Support Specialist provides limited reimbursement support services to healthcare providers and patients in… more
- HCA Healthcare (Aventura, FL)
- …and action taken on the account in accordance with policies and procedures. The Specialist will escalate medical review request and/or denial activities to the ... that invests in you as an Inpatient Authorization Review Specialist ? At Parallon you come first. HCA Healthcare has...the facilities, physicians' offices and/or insurance companies to resolve denials / appeals + Adhere to time and attendance… more
- Cardinal Health (Doral, FL)
- …in the appropriate system. + Manages and resolves complex insurance claims, including appeals and denials , to ensure timely and accurate reimbursement. + ... prioritizes getting the right things done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and...Processes denials & rejections for re-submission (billing) in accordance with… more