- Tufts Medicine (Melrose, MA)
- …health insurers, follows up with health insurers about submitted claims, and performs appeals for non-clinical denials , etc. An organizational related support or ... service (administrative or clerical) role or a role that focuses on support of daily business activities (eg, technical, clinical, non-clinical) operating in a "hands on" environment. The majority of time is spent in the delivery of support services or… more
- Tufts Medicine (Tyngsboro, MA)
- …health insurers, follows up with health insurers about submitted claims, and performs appeals for non-clinical denials , etc. An organizational related support or ... service (administrative or clerical) role or a role that focuses on support of daily business activities (eg, technical, clinical, non-clinical) operating in a "hands on" environment. The majority of time is spent in the delivery of support services or… more
- Robert Half Finance & Accounting (Colorado Springs, CO)
- …through third-party clearinghouses, ensuring timely processing. * Post and process verified denials during accounts receivable activities. * Submit appeals for ... denied claims and handle overpayments from third-party payers. * Collaborate with government and third-party insurers to follow up on missing or improperly denied claims. * Support the team by verifying eligibility and benefits for in-office surgeries,… more
- WMCHealth (Valhalla, NY)
- …+ Keeps abreast of regulatory changes affecting coding. + Reviews denials from insurance companies and drafts appeals . Qualifications/Requirements: Experience: ... Minimum of 2-3 years related experience in acute car environment; must be proficient with multiple EMR systems, 3M Encoder and have a minimum of 5 years' experience specializing in inpatient. Education: Bachelor's degree in a health related field, required. Or… more
- Bear Mountain Health Care (MA)
- …resident responsibility, discuss Patient Liability payments, per policy . Respond to denials , which may include attendance of appeals or submission of ... reapplication . Work in collaboration with the facility Business Office staff to coordinate efforts to approval . Prepare reports and attend Medicaid Pending meetings with Regional team Requirements include: . Strong knowledge of the Medicaid application… more
- Fallon Health (Worcester, MA)
- …regarding the grievance/appeal. + Acts as the initial investigator for provider appeals related to filing limit, claim denials , claim payment, retrospective ... on Facebook, Twitter and LinkedIn. **Brief summary of purpose:** Fallon Health (FH) Appeals and Grievance process is an essential function to FH's compliance with… more
- Insight Global (Nottingham, MD)
- …hospital centers in Washington, DC. This role focuses on resolving underpayments, denials , and contract interpretation issues-not clinical denials or patient ... follow up, specifically to BCBS. The role focuses on resolving technical denials (underpayment or partial payment issues, authorization issues, COB issues, coding… more
- NTT America, Inc. (Plano, TX)
- …Manager to join our team. NTT DATA is seeking to hire a **Medicare Appeals Clinical Leader** to lead service delivery engagements and improve end-to-end delivery of ... Medicare Appeals . Desire experience specifically for processes for clinical ...interpret medical records, documenting recommendations to uphold or overturn denials + Excellent analytical and problem-solving skills + Strong… more
- Adecco US, Inc. (Mesa, AZ)
- …AZ. This position will be **fully remote** and will be responsible for resolving denials on medical or behavioral claims. The Medical Collector will also follow up ... billing. The Medical Collector will also monitor payer response files, resolve denials by obtaining payment or performing write off adjustments, research root cause… more
- Beth Israel Lahey Health (Charlestown, MA)
- …effective resolution of denied claims with the purpose of reducing overall denials and increasing revenue. This includes interpreting payment and denial data down ... be appealed. Responsible for writing timely, comprehensive and compelling appeals to third party payers in order to get...Performs ongoing analysis to determine the root cause of denials and makes well thought out recommendations for workflow,… more