- Select Medical (Harrisburg, PA)
- … insurance approvals and authorizations, as well as facilitating appeals for patients + Demonstrates positive referrer satisfaction and account retention. ... experience in a related position preferred. + Experience with insurance approvals, prior authorizations, and the appeals ...with insurance approvals, prior authorizations, and the appeals process. + Experience in workers' compensation is a… more
- Fallon Health (Worcester, MA)
- …we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for ... on Facebook, Twitter and LinkedIn. **Brief summary or purpose:** Fallon Health (FH) Appeals and Grievance process is an essential function to FH's compliance with… more
- Rush University Medical Center (Chicago, IL)
- …of each case. **Summary:** This position reviews initial clinical denials, document appeals for clinical inpatient denials, conducts appeals as appropriate. ... outcomes, identify trends and work collaboratively with clinical providers, coders, insurance companies and revenue cycle leadership to prevent future clinical… more
- Henry Ford Health System (Troy, MI)
- GENERAL SUMMARY: This position is responsible for receiving, analyzing, and assigning Appeals , Grievances and Complaints (A&G) to the A&G Analysts. Responsible for ... staff with administrative duties, statistical data on the activity of Appeals , Reconsideration, Redeterminations and Grievances, which will identify trends and… more
- Houston Methodist (Sugar Land, TX)
- …utilization review activities, and monitoring the clinical denial management and appeals process, as applicable, in collaboration with clinical team partners. This ... or equivalent revenue cycle clinical role + Experience includes writing clinical appeals for medical necessity compliance or level of care for government and… more
- Baylor Scott & White Health (Dallas, TX)
- …Center Appeal Support Specialist is responsible for ensuring that complete and accurate appeals of denied claims are submitted to the payer in a timely manner ... The Appeal Support Specialist processes submissions of reconsiderations, redeterminations, appeals , resubmissions of previously submitted appeals , submissions of… more
- MyFlorida (Tallahassee, FL)
- …Tool (https://compcalculator.myflorida.com/) Senior Benefits Analyst Division of State Group Insurance State of Florida Department of Management Services This ... the following: Member and Customer Support: a. Level II Enrollment and Eligibility Appeals : performs research sufficient to address all issues raised in appeals ;… more
- AssistRx (Orlando, FL)
- …therapies that they need. This role works directly with healthcare providers & insurance plans/payers to gather information about a patient's insurance and the ... coverage provided for a specific pharmaceutical product. The Insurance Verification Specialist will support the healthcare providers addressing questions regarding… more
- AssistRx (Maitland, FL)
- …therapies that they need. This role works directly with healthcare providers & insurance plans/payers to gather information about a patient's insurance and the ... coverage provided for a specific pharmaceutical product. The Insurance Verification Specialist will support the healthcare providers addressing questions regarding… more
- Guidehouse (El Segundo, CA)
- …and three days from home._** **Essential Job Functions** + Account Review + Appeals & Denials + Medicare/Medicaid + Insurance Follow-up + Customer Service ... None **Clearance Required** **:** None **What You Will Do** **:** The ** Insurance Patient Account Representative** **(Hospital Claims)** is an extension of a… more
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