• Lead Appeal and Denial Specialist

    Sanford Health (SD)
    … documentation, and interpreting medical policies. The As a lead position, lead appeals and denial specialist this role will additional support the leads ... or remote **Job Summary** Responsible for performing advanced level work related to appeals and denials by conducting a comprehensive review of clinical more
    Sanford Health (01/06/26)
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  • Behavioral Health Specialist , Social Work…

    State of Colorado (Colorado Springs, CO)
    Behavioral Health Specialist , Social Work / Counselor III - Spring Creek Youth Services Center Print ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5169878) Apply  Behavioral Health Specialist , Social Work / Counselor III - Spring Creek Youth… more
    State of Colorado (12/13/25)
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  • Inpatient Coding Denials Specialist

    Fairview Health Services (St. Paul, MN)
    …the development of denial reports and other statistical reports. + Collaborates with Clinical Denials Nurse Specialist and Leadership in high-dollar claim denial ... **Job Overview** The Inpatient Coding Denials Specialist performs appropriate efforts to ensure receipt of...records and coding guidelines to formulate coding arguments for appeals and/or coding guidance for potential re-bills. Maintains a… more
    Fairview Health Services (11/29/25)
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  • Revenue Cycle Specialist III (Hhp Hamg…

    Cedars-Sinai (Torrance, CA)
    …and resolve denied or underpaid claims; prepare and submit timely, accurate written appeals with supporting clinical / billing documentations in accordance with ... I be doing in this role?** The Revenue Cycle Specialist III works under general supervision and following established...including progress notes, lab results, pathology reports, and other clinical records, to support accurate billing, appeals ,… more
    Cedars-Sinai (12/04/25)
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  • Insurance Specialist II - Corporate Patient…

    Guthrie (Sayre, PA)
    Position Summary: Fulfills all requirements of Insurance Specialist I, as well as serving as a group leader by participating in staffing and employment issues. ... Serves as a resource specialist within the department. Trains Insurance Billing Specialists I...to complete all types of complex insurance billings and appeals . Reviews and analyzes the insurance processing procedures to… more
    Guthrie (11/19/25)
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  • Revenue Cycle Specialist for Specialty…

    Trinity Health (Fort Wayne, IN)
    …Type:** Full time **Shift:** **Description:** The Specialty Pharmacy Revenue Cycle Specialist is responsible for performing the appropriate processes to obtain and ... completes necessary forms, and submits authorization requests. Collaborates with Clinical Staff to ensure appropriateness of the prior authorization documentation… more
    Trinity Health (12/14/25)
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  • Prior Authorization Specialist

    US Tech Solutions (May, OK)
    …with other internal groups regarding determination status and results (seniors, pharmacists, appeals , etc). + Identify and elevate clinical inquiries to the ... **Job Description:** The Rep I, Clinical Services takes in-bound calls from providers, pharmacies,...resolve coverage requests. Escalate issues to Coverage Determinations and Appeals Learning Advocates and management team as needed. Must… more
    US Tech Solutions (10/17/25)
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  • Social Work/Counselor I- Benefits…

    State of Colorado (Pueblo, CO)
    Social Work/Counselor I- Benefits Specialist - CMHHIP Social Work Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5041418) Apply  Social ... Work/Counselor I- Benefits Specialist - CMHHIP Social Work Salary $32.68 - $45.75...environmental resources, and support systems. This assessment generates a clinical summary and treatment recommendations that predictably affects treatment… more
    State of Colorado (11/13/25)
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  • Utilization Review Specialist

    BriteLife Recovery (Englewood, NJ)
    clinical information and advocating for appropriate levels of care. The UR Specialist works closely with clinical staff, admissions, medical providers, and ... What you will be doing? The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced Revenue Solutions and is responsible for… more
    BriteLife Recovery (01/05/26)
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  • Medical Accounts Receivable Specialist

    Robert Half Accountemps (Indianapolis, IN)
    …directly with payers to follow up on outstanding claims, submit technical and clinical appeals , resolve payment variances, and secure timely and accurate ... Description Our company is seeking a talented Medical Accounts Receivable Specialist to join our team in a fully remote capacity. The ideal candidate is… more
    Robert Half Accountemps (12/24/25)
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