- MetLife (Oriskany, NY)
- Long Term Disability Claims Specialist I Job Location: Virtual but must be commutable to the following office locations: * Aurora, IL * Bloomfield, CT * Cary, NC * ... with both external and internal resources, such as physicians, attorneys, clinical /vocational consultants as needed to gather data such as medical/occupational… more
- MetLife (Cary, NC)
- Long Term Disability Claims Specialist II Job Location: Virtual but must be commutable to the following office locations: * Aurora, IL * Bloomfield, CT * Cary, NC * ... with both external and internal resources, such as physicians, attorneys, clinical /vocational consultants as needed to gather data such as medical/occupational… more
- St. Luke's Health System (Boise, ID)
- …truly a great place to work. **Overview:** The Senior Pharmacy Benefits Specialist assists our members in identifying and navigating complex pharmacy benefits ... of all new pharmacy benefits team members. + Review the supporting clinical documentation provided by a patient's prescriber and validate that information against… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- …Brighton Health Plan Solutions (BHPS) is seeking an experienced Claim Dispute Specialist skilled in investigating and resolving provider payment disputes by our ... of claims and medical documentation. + Prepare cases for clinical review. + Resolve and provide accurate and timely...issues. + Strong knowledge of contracts, medical terminology, and appeals processing and procedures. + High School Diploma or… more
- UNC Health Care (Goldsboro, NC)
- …of the unique communities we serve. Summary: The Medicaid Eligibility Specialist screens, coordinates and facilitates the Medicaid application process across ... for Medical Assistance Programs. 3. Performs analysis of patient's assets, income, clinical history and dependent responsibilities. This must be done based on… more
- University of Virginia (Charlottesville, VA)
- The Central Billing Office (CBO) Insurance Resolution Specialist handles and resolves all Insurance billing follow up and denial issues to ensure all facilities ... AR responsibility. + Performs inpatient/outpatient follow up and working insurance denials, appeals claims as defined by payer and departmental rules. + Resolves… more
- Intermountain Health (Phoenix, AZ)
- …provides advanced training to hospital coding staff, compliance, CDI, physicians, and clinical staff. This Coordinator serves as a subject matter expert for all ... of hospital coding. The coordinator works with providers and clinical staff to make critical coding decisions based on...compliance and the CDI team. + Audits and creates appeals for all payer and regulatory denials and downgrades… more
- University of Utah Health (Salt Lake City, UT)
- …+ Resolves clinical and/or authorization denials through CARC analysis and appeals - including clinical documentation review and coordination with UR and/or ... **Employment Type** _Full-Time_ **Shift** _Day_ **Work Schedule** _Monday-Friday, 8am-4:30pm_ ** Clinical /Non- Clinical Status** _Non-Clinical_ **Location Name** _Business Services… more
- Option Care Health (Oklahoma City, OK)
- …patients with acute and chronic conditions in all 50 states. Through our clinical leadership, expertise and national scale, Option Care Health is re-imagining the ... Assists with Billing and Collection Training and completes "second level" appeals to payers. **Job Description:** **Job Responsibilities:** + Submits timely,… more
- Indian Health Service (Parker, AZ)
- …Responds to third party requirements on post-payment reviews, exclusions, denials and appeals for Parker Service Unit. Performs daily in-patient interviews to obtain ... OR Specialized Experience: Progressively responsible analytical or administrative, or clinical management or supervisory experience in the health care field.… more