- Nuvance Health (Danbury, CT)
- …This role is instrumental in liaising with all above parties to submit provider appeals to insurance companies including Medicare and Medicaid for the Nuvance ... Provides high quality administrative support to Clinical Denial Prevention & Appeals Specialist RNs, Physician Advisors (PAs) and other stakeholders in ensuring… more
- Elevance Health (Richmond, VA)
- **Medical Director-Dermatology Appeals ** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training ... is granted as required by law. The **Medical Director-Dermatology Appeals ** is responsible for the review of appeals...of care opportunities. May serve as a resource to staff including Medical Director Associates. May be responsible for… more
- City of New York (New York, NY)
- …enthusiastic Trial Preparation Assistant, Level II (TPA II) to assist Appeals Bureau Assistant District Attorneys with post-conviction matters. JOB RESPONSIBILITIES: ... court - Help maintain and make entries in various Appeals Bureau databases - Perform all other duties as...communication skills and ability to interact professionally with court staff , agency staff , and external agency … more
- Elevance Health (Indianapolis, IN)
- …for system edits. + Coordinates research and responds to system inquiries and appeals . + Conducts research of claims systems and system edits to identify ... to providers regarding coding and fee schedule updates. + Trains customer service staff on system issues. + Works with providers contracting staff when… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Appeals Specialist II, under the direction of the Director of Denial Support Services, logs and reviews per documentation guidelines for report ... + Responsible for review and resolution of pre pay insurance denials, correlating with the follow-up teams. + Works...education and payer accountability. + Consults with managers and staff on developmental needs for new processes and makes… 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
- City of New York (New York, NY)
- …enthusiastic Trial Preparation Assistant, Level II (TPA II) to assist Appeals Bureau Assistant District Attorneys with post-conviction matters. JOB RESPONSIBILITIES: ... court services - Ability to effectively and professionally communicate with court staff and judges - Excellent time management skills Strong desire and ability… more
- Johns Hopkins University (Middle River, MD)
- …the collection of unpaid third-party claims and independent resolution of complex appeals , using various JHM applications and JHU/ PBS billing applications. Will ... high-cost procedures. Will incorporate research findings on medical policy into appeals documentation. Communicates with payers to resolve issues and facilitate… more
- Mount Sinai Health System (New York, NY)
- …in the department as per protocol + Requests or provides Medical Records as required for appeals , On / Off-site Insurance reviews + Implements first step of ... in Allscripts + Meets time frame for reviews / appeals as specified by Insurance / State...professional image. + Participates in the development of other staff members. + Meets regulatory, licensure and annual health… more
- Johns Hopkins University (Middle River, MD)
- …for the basic collection of unpaid third-party claims and standard appeals , using various JHM applications and JHU/ PBS billing applications. Communicates ... payers to resolve issues and facilitate prompt payment of claims. Follow-up with insurance companies to collect outstanding accounts for which payment has not been… more