- Centene Corporation (Austin, TX)
- …optimize outcomes. + Collaborates effectively with clinical teams, network providers, appeals team, medical and pharmacy consultants for reviewing complex cases and ... medical necessity appeals . + Participates in provider network development and new...work in the areas of Health Administration, Health Financing, Insurance , and/or Personnel Management is advantageous. + Experience treating… more
- Ochsner Health (New Orleans, LA)
- …The Appeals Specialist is responsible for managing and resolving insurance claim denials and underpayments to ensure accurate reimbursement. This role involves ... Preferred - + Experience in healthcare or revenue cycle - specifically insurance claim denials. + Strong analytical and organizational skills. + Excellent… more
- Modivcare (Ridgeland, MS)
- …right fit for you! Modivcare is looking for an experienced Grievances & Appeals Specialist to join our team! This position is responsible for establishing superior ... to include the following: + Medical, Dental, and Vision insurance + Employer Paid Basic Life Insurance ...Vision insurance + Employer Paid Basic Life Insurance and AD&D + Voluntary Life Insurance … more
- Trinity Health (Fort Wayne, IN)
- …in the appropriate system for each contact made to the patient, provider, and insurance plan. Facilitates appeals process between the patient, physician, and ... for performing the appropriate processes to obtain and verify patient insurance eligibility and benefits, prior authorizations as needed, schedule delivery of… more
- St. Luke's University Health Network (Allentown, PA)
- …regardless of a patient's ability to pay for health care. The Coding Appeals Specialist analyzes patient medical records, claims data and coding on all diagnosis ... MS-DRG for the purposes of appealing proposed MS-DRG and coding changes by insurance providers or their auditors. Assures that the most accurate and descriptive… more
- AbbVie (North Chicago, IL)
- …a subject matter expert on commercial pharmacy, major medical, and government insurance plans, prior authorizations, appeals , and alternate coverage referrals. ... LinkedIn and Tik Tok (https://www.tiktok.com/@abbvie) . Job Description The Supervisor, Insurance Analyst provides leadership, support, and supervision for the … more
- Cardinal Health (Denver, CO)
- …maintain optimal account receivables performance and client satisfaction. + Resolves complex insurance claims, including appeals and denials, to ensure timely ... as a subject matter expert in claims processing. + Processes claims: investigates insurance claims; properly resolves by follow-up & disposition. + Lead and manage… more
- Covenant Health Inc. (Knoxville, TN)
- …/precert verification, registration, Health Information Management (HIM), coding, claims management/ insurance follow-up or appeals etc.). Will consider ... submission/resubmission, and/or appeal of rejected, denied, unpaid, or improperly paid insurance claims. This position is responsible for billing and follow-up… more
- Corewell Health (Grand Rapids, MI)
- …and/or verifies that prior authorization has been obtained; assists with retroactive insurance denials/ appeals . + Responsible for complex EMR/EHR scanning and ... High School Diploma or equivalent + 2 years of relevant experience insurance billing, access management, patient financial services, electronic health records, lab… more
- Corewell Health (Ludington, MI)
- …and/or verifies that prior authorization has been obtained; assists with retroactive insurance denials/ appeals . + Responsible for complex EMR/EHR scanning and ... High School Diploma or equivalent + 2 years of relevant experience insurance billing, access management, patient financial services, electronic health records, lab… more