- Bristol Myers Squibb (Tampa, FL)
- …for escalation and resolution of Tier 2 queries, plan interpretation and appeals . + Responsible for ensuring internal processes are documented and updated versions ... Workday, ServiceNow, ADP and vendor management. + Certified Employee Benefits Specialist (CEBS) or equivalent Industry designation, preferred. \#LI-Hybrid If you… more
- AdventHealth (Tampa, FL)
- …analyze claim denials to perform the appropriate resolution, rebilling, and/or appeals steps. Assists with developing and implementing strategies and procedures to ... or + Certified Pension Consultant (CPC) Required or + CCS-Certified Coding Specialist Required This facility is an equal opportunity employer and complies with… more
- Rochester Regional Health (Rochester, NY)
- …Hours: 37.5 SCHEDULE: Monday-Friday 8AM-4PM SUMMARY: A Medical Billing and Denials Specialist is responsible for managing the billing process, submitting claims to ... timely and accurate account resolution in line with payer requirements. + Appeals & Reimbursement Review: Conduct detailed reviews of denied or underpaid claims,… more
- Molina Healthcare (Long Beach, CA)
- …in this role. Productivity is important with quick turnaround times. Experience with Appeals , Auditing, and Compliance /Quality will be a good fit for this position. ... of practice. * Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management… more
- Cardinal Health (Sacramento, CA)
- …skills and prioritizes getting the right things done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will ... the appropriate system. + Manages and resolves complex insurance claims, including appeals and denials, to ensure timely and accurate reimbursement. + Processes… more
- CVS Health (Madison, WI)
- …areas. Knowledge of Aetna clinical and coding policy and experience with appeals , claim review, reimbursement issues, and coding is preferable, but a willingness ... license in physical therapist or occupational therapist * Seating Mobility Specialist (SMS) Rehabilitation Engineering & Assistive Technology Society of North… more
- Stanford University (Stanford, CA)
- …for prospective donors as needed. + Renews giving, designs and manages appeals , increases giving levels, and recaptures lapsed donors. + Supports aligned gift ... the Major Gift Leadership Team meetings and the monthly Development Specialist Gift Officer meetings. + Leads the development and drivestheimplementation of… more
- State of Colorado (Colorado Springs, CO)
- …and Personnel Director's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, at spb.colorado.gov/board-rules . Supplemental Information Please ... the selection process and will be reviewed by a qualified Human Resources Specialist to determine if applicants meet the minimum qualifications for this position.… more
- Deloitte (Miami, FL)
- …accelerate their path to value creation. Work You'll Do As a Project Delivery Specialist on the project, you will work independently to solve complex problems and ... + Demonstrated ability to write clearly, succinctly, and in a manner that appeals to a wide audience. + Proficiency in word processing, spreadsheet, and presentation… more
- Centene Corporation (Jefferson City, MO)
- …Develop and maintain the audit process and tools related to: authorizations, appeals , quality events, and case management in CCMS; interrater reliability related to ... Coordinate auditing outcomes and system maintenance with the Sr. + Clinical Systems Specialist to resolve or enhance clinical systems + Performs other duties as… more