- US Physical Therapy (Uniondale, NY)
- …Manage commercial insurance claims from submission through payment + Follow up on denials , rejections, and appeals to ensure reimbursement + Communicate with ... insurance carriers and patients to resolve issues + Track A/R reports and maintain accurate patient account records + Collaborate with team members to improve billing and collection processes **Qualifications** + 2+ years of experience in medical… more
- Avera (Sioux Falls, SD)
- …up of unpaid, overpaid/over adjusted and denied claims. + Reviews, analyzes, and appeals denials received relative to claims processing issues with insurance ... payers. + Communicates with internal and external customers involved in the claims resolution process to ensure timely claims processing.) Identifies the need to rebill claims through account review and completes claim refiling as well as submits secondary… more
- AnMed Health (Anderson, SC)
- …rules and regulations pertaining 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… more
- Trinity Health (Nampa, ID)
- …needed and requested by third party payers and Medicaid. + Responsible for appeals , denials , as appropriate. Utilizes physician advisor referral as appropriate. ... + Will adhere to department established process in reviewing 30 day re-admissions. + Follows established patient choice policy. + Documents assessment of primary and back up plans along with communications to patient , family and care team. + Participates in… more
- New York State Civil Service (New York, NY)
- …use disorder parity laws including rates of medical necessity approvals and denials , rates of appeals , claims paid; and cost-sharing requirements;* Reviews ... the health care provider networks of insurers to ensure that the networks are sufficient to meet the health care needs of insureds and comply with requirements for mental health and substance use disorder services; * Performs legal research of court decisions… more
- Penn Medicine (East Petersburg, PA)
- …shape our future each day. Are you living your life's work? Job: Denials Management Specialist Hours: Day shift hours, start time between 07:00am-9:00am (8 hour ... are met in an appropriate manner. Responsibilities: + Analyzes and researches denials and follows-up with the appropriate payor, practice, and/or patient to resolve… more
- Catholic Health Initiatives (Omaha, NE)
- …to address and resolve outstanding insurance balances related to coding denials in accordance with established standards, guidelines and requirements. The incumbent ... advices, researching denial reasons and resolving issues through well-written appeals . Work requires proactive troubleshooting, significant attention to detail and… more
- University of Michigan (Ann Arbor, MI)
- Utilization Rev Appeals Spec Apply Now **Job Summary** **Why Join Michigan Medicine's Hospital Billing Audits & Appeals (HBAA) Department?** The Audit and ... knowledgeable about insurance requirements and medical billing practices. The Appeals Specialist will collaborate with multiple departments to maintain compliance… more
- Robert Half Office Team (Carmel, IN)
- Description Our team is seeking a detail-oriented Medical Denials Specialist to join a fast-paced healthcare environment and ensure accurate, timely resolution of ... communicate with payers to facilitate claim resolution. + Prepare and submit appeals and supporting documentation as needed. + Collaborate with billing staff,… more
- LA Care Health Plan (Los Angeles, CA)
- Lead Customer Solution Center Appeals and Grievances RN Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position ... that purpose. Job Summary The Lead Customer Solution Center Appeals and Grievances RN is responsible for assisting with... and grievances to find the root cause of denials . Duties Continued Check, verifies and ensure that all… more