- CaroMont Health (Gastonia, NC)
- …physicians regarding utilization issues. Collaborates with discharge planning specialist and other disciplines. Retrospectively reviews discharged medical record ... via fax, Provider Link, or telephonically. Gathers and disseminates Utilization Management information to medical staff departments, Nursing departments, Care … more
- Alabama Oncology (Birmingham, AL)
- …Business Office Summary: Under general supervision, an AR Account Follow-Up Specialist is responsible for account follow-up for all assigned accounts, resolving ... receivable current including monitoring for delinquent payments. The Account Follow-Up Specialist will review insurance claims and take the appropriate action,… more
- BriteLife Recovery (Englewood, NJ)
- …+ Maintain compliance with payer policies, HIPAA regulations, and internal utilization management protocols. + Monitor trends in denials , approvals, and ... What you will be doing? The Utilization Review (UR) Specialist is a critical member of the administrative team...of 2-3 years of experience in utilization review, case management , or insurance coordination in a behavioral health or… more
- TEKsystems (Canoga Park, CA)
- …(LVN) or Registered Nurse (RN) with hands-on experience in Utilization Management (UM) and a strong understanding of HMO/Medicare claims processes. ... all claim review activities + Participate in special projects related to claim denials and appeals Required Qualifications: + Active LVN or RN license (California) +… more
- Henry Ford Health System (Detroit, MI)
- …ensure compliant claims to Third party payers. Resolves problem accounts from payer denials and follows up on any claims that require a payer response. Responsible ... knowledge in all claims processing, including claims submissions , denials , and follow up procedures used to train other...team members + Independently interact with various levels of management , physicians , clinic personnel to identify process… more
- Nuvance Health (Danbury, CT)
- …for the assigned areai? 1/2s claims submission, payment application, denial management , and account follow-up to ensure optimal reimbursement. Responsibilities: 1. ... all delinquent claims. 3. Responds to all patient and payer inquiries, denials , correspondence and telephone inquiries. 4. Advises other areas of updated insurance… more
- Philips (Chicago, IL)
- …or Reimbursement Services. + Your skills include: + Experience with denial management , claim follow up, overturning denials and identifying payer issue ... + Working with various commercial insurnace payers to resolve claims and denials . + Escalating payor issue trends for leaderships consideration along with possible… more
- SERV Behavioral Health System (Hamilton, NJ)
- …JOB SUMMARY: Reporting to the Billing Manager, the Senior Accounts Receivable Specialist will be responsible for billing and submitting claims and handling escalated ... billing and collection issues. The Senior Accounts receivable specialist serves as a subject matter expert in complex accounts receivable processes including denied… more
- Molina Healthcare (San Antonio, TX)
- …and eligibility criteria. * Experience with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines for appeals ... and denials . * Customer service experience. * Strong organizational and time management skills; ability to manage simultaneous projects and tasks to meet… more
- Molina Healthcare (Kenosha, WI)
- …and eligibility criteria. * Experience with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines for appeals ... and denials . * Customer service experience. * Strong organizational and time management skills; ability to manage simultaneous projects and tasks to meet… more