- Molina Healthcare (Warren, MI)
- …work on set schedule) Looking for a RN with experience with appeals, claims review, and medical coding. **Job Summary** Utilizing clinical knowledge and experience, ... Duties** + Performs clinical/medical reviews of retrospective medical claim reviews, medical claims and previously denied cases, in which an appeal has been… more
- Molina Healthcare (Richmond County, GA)
- …Responsible for reviewing and resolving Medicare member appeals and Medicare claims in communicating resolution to members and provider (or authorized ... to ensure that internal and/or regulatory timelines are met. + Research claims appeals using support systems to determine Medicare appeal and claim outcomes.… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …Assists in the review of Bon Secours Mercy Health coding, billing and claims processing policies and procedures for the development of compliance internal monitors ... periodic review and analysis of Bon Secours Mercy Health hospital claims denial reports, operational assessment reports, internal quality control reviews, internal… more
- LogixHealth (Dania Beach, FL)
- …Required: + Minimum 2-3 years of A/R follow-up experience in professional healthcare billing + Familiarity with payer regulations, claims appeals processes, ... provide cutting edge solutions that will directly improve the healthcare industry. You'll contribute to our fast-paced, collaborative environment...A/R (Accounts Receivable) reports to follow up on unpaid claims + Send out appeals on claims … more
- HCA Healthcare (Nashville, TN)
- …to join an organization that invests in you as a Case Manager SME? At HCA Healthcare , you come first. HCA Healthcare has committed up to $300 million in programs ... members over the course of three years. **Benefits** HCA Healthcare offers a total rewards package that supports the...and HCA's legal team to assess the validity of claims and assist in the pursuit of payment on… more
- Molina Healthcare (Spokane, WA)
- …to ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance ... assures timeliness and appropriateness of responses per state, federal and Molina Healthcare guidelines. + Responsible for meeting production standards set by the… more
- Onsight Healthcare - Healthcare Hospitality Group (New Orleans, LA)
- …Job Shift Any Job Category Site Manager Description Transportation Site Manager Onsight Healthcare has been contracted to support a new confidential client in the ... individual with a tenacious work ethic and compassionate personality? Onsight Healthcare is seeking an experienced, hands-on manager and people-leader to join… more
- Two95 International Inc. (New York, NY)
- …research preferred (but not required) * 10+ years of experience in healthcare data analysis (including EMR/EHR, claims , eligibility and publicly available ... will meet their needs * Lead the discovery of the client's EMR/EHR and/or claims data environment so we can efficiently and effectively navigate and do the analyses… more
- Molina Healthcare (Dayton, OH)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... Hospital payment methodology & processing is essential + Understanding on hospital claims processing and configuration works + Medicare fee schedule knowledge is… more
- Advocates (Framingham, MA)
- … claims through phone and written communication with employees, supervisors, healthcare providers, and other stakeholders. + Adjudicate claims in accordance ... key member of the Benefits Team and is responsible for managing employee leave claims , including FMLA, state Paid Family Leave (PFL), ADA, and other leave programs.… more