- Molina Healthcare (Green Bay, WI)
- …to healthcare premium. * Assist in resolution for escalated premium issues with Appeals and Grievances team members. * Guide and collaborates with enrollment team to ... resolve eligibility issues affecting premium billing. * Generate billing data using the QNXT premium billing module to be sent to print and fulfillment vendor. * Reconcile unallocated payments on a daily basis. * Resolve orphan member payments on a daily… more
- Penn Medicine (East Petersburg, PA)
- …to expedite the resolution of the denied claim. + Performs all appeals and denial recovery procedures needed to appropriately and accurately resolve denied ... claims. + Processes required adjustments to accounts, including charges credits, payment transfers, policy adjustments, etc. in a timely and accurate manner. + Maintains a thorough knowledge and understanding of all assigned payor contracts and requirements. +… more
- AnMed Health (Anderson, SC)
- …to compliance in billing. Responsible for researching denials and initiating appeals , when necessary. Scans and indexes all patient information accurately and ... in a timely manner. Balances cash, patient payments, and GL entries to accounting reports daily. Must be able to interact with patients and the general public respectfully and professionally. Maintains and exhibits a positive, supportive and safety conscious… more
- Logan Health (Kalispell, MT)
- …processing as applicable to assigned area(s). + Responsible for all insurance appeals and works with appropriate stakeholders to ensure completion as applicable to ... assigned area(s). + Serves as point of contact for quotes, equipment authorization, etc. as applicable to assigned area(s). + The above essential functions are representative of major duties of positions in this job classification. Specific duties and… more
- City and County of San Francisco (San Francisco, CA)
- …The terms of this announcement may be appealed under Civil Service Rule 110.4. Such appeals must be submitted in writing to the Department of Human Resources, 1 S ... Van Ness Avenue, 4th Floor, San Francisco, CA 94103-5413 by close of business on the 5th business day following the issuance date of this examination announcement. Information concerning other Civil Service Commission Rules involving announcements,… more
- Robert Half Finance & Accounting (Mundelein, IL)
- …rates according to client requirements. + Management of timekeepers and coordinate/process appeals as required. + Ability to execute complex bills in a timely ... manner (ie, multiple discounts by matter, split billing, preparation, submission and troubleshooting of electronic bills). + Monitor outstanding Work in Process (WIP) and Accounts Receivable (AR) balances. Collaborate with billing attorneys to ensure WIP is… more
- St. Bernard's Medical Center (Jonesboro, AR)
- …reports every morning. Calling insurances to follow up on payment status or appeals due to denials or incorrect payments. Calling patients for insurance information ... and arrange payment plan if one is needed. This position requires timely response to inquiries from both the payer and the patient. This position has high contact with patients, employees, physicians, and other members of the community. Occasional stress… more
- Commonwealth Care Alliance (Boston, MA)
- …issues. + Collaborate closely with Provider Relations, Contracting, Payment Integrity, Appeals & Grievances, and Configuration teams to validate and resolve ... reimbursement concerns. + Conduct retrospective audits to identify systemic payment issues and recommend resolution pathways. + Interpret and apply MassHealth fee schedules, All-Payer Rate Setting regulations, and CMS payment methodologies (eg, DRG, APC,… more
- Intermountain Health (Murray, UT)
- **Job Description:** This position provides expertise in the areas of appeals and grievances for highly regulated insurance plans with unique plan designs, ... interviews and meetings** This analyst position investigates, examines and reviews appeals and grievances in accordance with state and federal insurance regulations,… more
- Hartford HealthCare (Farmington, CT)
- …and other common practices across the system. *_Position Summary:_* The Denial Specialist is responsible for reviewing, analyzing and appealing denials related to ... Key responsibilities include timely investigation of DRG downgrades, submitting appeals , coordinating follow-up actions and ensuring compliance with regulatory… more