- Molina Healthcare (Bellevue, WA)
- …appropriate appeals and grievance outcomes. * Requests and reviews medical records, notes, and/or detailed bills as appropriate; formulates conclusions per ... and Marketplace benefits and services including reviewing and resolving member appeals and complaints, then communicating resolution to members or authorized… more
- Molina Healthcare (Bellevue, WA)
- …Services (CMS). **Essential Job Duties** * Enters denials and requests for appeals into information system and prepares documentation for further review. * ... systems and other available resources. * Assures timeliness and appropriateness of appeals according to state, federal and Molina guidelines. * Requests and obtains… more
- Molina Healthcare (Spokane, WA)
- …+ Responsible for the comprehensive research and resolution of the appeals , dispute, grievances, and/or complaints from Molina members, providers and related ... ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance outcomes.… more
- Molina Healthcare (Tacoma, WA)
- …**Provider No Surprise Act** cases outcomes. . * Requests and reviews medical records, notes, and/or detailed bills as appropriate; formulates conclusions per ... * At least 2 years of managed care experience in a call center, appeals , and/or claims environment, or equivalent combination of relevant education and experience. *… more
- Robert Half Legal (Mountlake Terrace, WA)
- …Robert Half is partnering with a Healthcare Organization searching for their next appeals specialist . This is an excellent opportunity for a motivated ... position is $21-$23/hr. Benefits available to contract/temporary professionals, include medical , vision, dental, and life and disability insurance. Hired… more
- Molina Healthcare (Tacoma, WA)
- …* Serves as a clinical resource for utilization management, chief medical officer, physicians, and member/provider inquiries/ appeals . * Provides training, ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse (RN) provides support for internal ...proficiency. **Preferred Qualifications** * Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager… more
- University of Washington (Seattle, WA)
- …the development, implementation, and evaluation of critical governance processes related to medical student academic progress, conduct, and appeals . The SPC ... **Job Description** **POSITION PURPOSE** The Academic Progress and Case Specialist serves as the program administrator responsible for the overall management, policy… more
- Spokane County (Spokane, WA)
- Property Information Specialist (OPEN & PROMOTIONAL) Print (https://www.governmentjobs.com/careers/spokanecountywa/jobs/newprint/5139081) Apply Property ... Information Specialist (OPEN & PROMOTIONAL) Salary $42,081.00 - $58,617.00 Annually...current employer-paid health and related benefit contribution rates (including medical , dental, life insurance, long term disability, and leave).… more
- Seattle Children's (Seattle, WA)
- …coding and documentation compliance. **Required Credentials** Certified Coding Specialist -Physician Based (CCS-P) certification by the American Health Information ... Experience in revenue cycle functions, including coding denial management and appeals process. Experience in research of payer policy and coding guidelines.… more
- Swedish Health Services (Seattle, WA)
- …agencies, medical service bureaus, and insurance companies. Submit claims appeals with supporting documentation as necessary and resolve aged insurance balances. ... Join our team at Swedish Health Services DBA Swedish Medical Group and thrive in our culture of patient-focused,...we must empower them. **Required Qualifications:** + 2 years medical (or healthcare) insurance follow up experience. **Why Join… more