- TEKsystems (Houston, TX)
- …this is not the simple call - this is a follow up that's been re-routed to the appeals specialist to do in the depth review of the denial letter to determine the ... revenue cycle appeal, revenue cycle specialist , denials specialist , appeals specialist , insurance follow...follow up, root cause analysis, EHR, EMR, EPIC, Cerner, medical billing, claims audit, appeals process, … more
- TEKsystems (Austin, TX)
- Overview We are seeking a highly analytical and proactive Revenue Cycle Appeals Specialist to join our team. This role is ideal for someone with strong ... experience in appeals , denials, and insurance follow-up within the healthcare revenue...for this temporary role may include the following: * Medical , dental & vision * Critical Illness, Accident, and… more
- Cognizant (Austin, TX)
- ** Appeals & Grievance Specialist (remote)** This is a remote position open to any qualified applicant in the United States. **Job Summary:** We are seeking a ... dedicated Appeals & Grievance Specialist with 2 to...or Grievance is legitimate. A strong understanding of Claims, Appeals and Medical Benefits. Referring suspicious or… more
- Molina Healthcare (Fort Worth, TX)
- …hours** Must be able to rotate weekends and holidays** Must have Medicare Appeals and IRE experience** Responsible for reviewing and resolving member and provider ... + Responsible for the comprehensive research and resolution of the appeals , dispute, grievances, and/or complaints from Molina members, providers and related… more
- Molina Healthcare (Austin, TX)
- …for letters and prepare responses to appeals and grievances. + Elevates appropriate appeals to the Appeals Specialist . + Generates and mails denial ... systems and other available resources. + Assures timeliness and appropriateness of appeals according to state and federal and Molina Healthcare guidelines. +… more
- Molina Healthcare (San Antonio, TX)
- …appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical/ medical reviews of previously ... + Serves as a clinical resource for Utilization Management, Chief Medical Officer, Physicians, and Member/Provider Inquiries/ Appeals . + Provides training,… more
- Houston Methodist (Houston, TX)
- …items that result in resolution. Engages the coding follow up team for any medical necessity or coding related appeals . + Assures accounts are completed and ... At Houston Methodist, the Revenue Cycle Specialist is responsible for providing direct and indirect...perform collections activities on complex denials and prepare complex appeals on outstanding insurance balances in the professional fee… more
- Houston Methodist (Sugar Land, TX)
- …management or equivalent revenue cycle clinical role + Experience includes writing clinical appeals for medical necessity compliance or level of care for ... At Houston Methodist, the Senior Denials Management Specialist position is responsible for performing utilization review...National Coverage Determination (NCD) + Competence in writing clinical appeals for medical necessity compliance or level… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Coding Charges & Denials Specialist is responsible for coordinating and monitoring the coding-specific clinical charges and denial ... management and appeals process in a collaborative environment with revenue cycle...denials, denial reason and trending, interpretation of payer manuals, medical policies, and local/national coverage determinations. **SERVICE ESSENTIAL FUNCTIONS**… more
- Urology Clinics of North Texas (Mesquite, TX)
- AR SPECIALIST Job Details Job Location 1650 Republic Pkwy Ste 150, Mesquite, TX 75150 - Mesquite, TX Position Type Full Time Education Level High School Travel ... for a customer-focused office professional to perform collections, filing claims, handle appeals , and correspondence with payers. This position will focus on claims… more