- LA Care Health Plan (Los Angeles, CA)
- Manager, Customer Solution Center Appeals and Grievances Job Category: Management/Executive Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, ... to achieve that purpose. Job Summary The Manager, Customer Solution Center Appeals and Grievances is responsible for the centralized intake, logging and triage… more
- St. Luke's University Health Network (Allentown, PA)
- …The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all diagnosis and procedure codes to ... determination made by the government or commercial payors, or their auditor representative . + Facilitate clinical chart reviews to assist with supporting assigned… more
- St. Luke's University Health Network (Allentown, PA)
- …health care. The Coding Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all diagnosis and procedure codes to ... AMA CPT, are assigned to support the services/treatment rendered. The Coding Appeals Specialist also prepares appeal arguments and/or letters to support and defend… more
- Sanford Health (ND)
- …40.00 **Salary Range:** $16.00 - $25.50 **Job Summary** The Insurance Representative processes and monitors unpaid third party insurance, Medicare, Medicaid or ... to work accounts throughout the entire revenue cycle. Prepares and submits claims to payers either electronically or by paper. Secures necessary medical… more
- UNC Health Care (Chapel Hill, NC)
- …philosophy. Job Responsibilities: + Responsible for the accurate and timely submission of claims follow up, reconsideration and appeals , response to denials, and ... payer, system or escalated account issues. + May maintain data tables for systems that support PB Claims... data tables for systems that support PB Claims operations. + Evaluate carrier and departmental information and… more
- TEKsystems (Philadelphia, PA)
- …Reviewing claims with no response. Reviewing denied claims or underpaid claims and resolving the denial and filing appeals , as necessary. Ensuring all ... by handling a significant amount of manual work, including data entry and QA support to review billing information....could be assigned to hospital, professional, or home care claims . + Submits timely, accurate claims to… more
- Owens & Minor (Columbus, OH)
- …The collections representative follows-up with insurance companies to resolve unpaid claims . The anticipated hourly range for this position is $12.21 - $17.04. ... customers on delinquent payments. + Reviews unpaid and underpaid claims . Resubmits or appeals as necessary. +...a strong ability to understand, interpret and develop spreadsheet data . **Other Skills** **PHYSICAL DEMANDS** This is a stationary… more
- SSM Health (Madison, WI)
- …and payment rules. Bills claims appropriately. + Follows up on denied claims by performing appeals and denial recovery procedures. Works denied claim lines ... or more of the following: processing insurance payments, following up on denied claims , and resolving credit balances. May work in multiple functional areas. **Job… more
- TEKsystems (Las Vegas, NV)
- …insurance information, and resolve recoupment issues + Access payer websites to gather data and resolve claims + Communicate system access issues, payor trends, ... are seeking a highly skilled and detail-oriented Patient Account Representative to join our Revenue Cycle team. This role...of medical collections experience including working with denials and appeals + Must sit in either the PST time… more
- University of Rochester (Rochester, NY)
- …edits, and obtains signatures for non-routine letters of correspondence related to appeals on denied claims , including compiling all necessary information and ... determined by considering factors including, but not limited to, market data , education, experience, qualifications, expertise of the individual, and internal equity… more