- AssistRx (Maitland, FL)
- …how to expedite patient access + Document and initiate prior authorization process and claims appeals + Report any reimbursement trends or delays in coverage to ... provided for a specific pharmaceutical product. The Insurance Verification Specialist will support the healthcare providers addressing questions regarding coding… more
- University of Virginia (Charlottesville, VA)
- …assigned AR responsibility. Performs inpatient/outpatient follow up and working insurance denials, appeals claims as defined by payer and departmental rules. ... The Central Billing Office (CBO) Insurance Resolution Specialist handles and resolves all Insurance billing follow...from insurance companies. They are responsible of ensuring all claims billed are in compliance with all federal and… more
- CVS Health (Franklin, TN)
- …standards, and policies to provide effective and timely support. + Reviews pre-specified claims or claims that exceed specialist adjudication authority or ... **A Brief Overview** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with claim processing guidelines. **What you will do**… more
- Amergis (Columbia, MD)
- …follows up on unpaid accounts after expected payment timeframe + Corrects, resubmits claims and/or appeals claim determinations as necessary to ensure payment + ... staffing experiences to deliver the best workforce solutions. The Reimbursement Specialist I reviews branch sales for appropriate documentation, generate and bill… more
- Great River Health (Fort Madison, IA)
- …Coordinates and assists in reimbursement for services provided. Accurately files insurance claims for the purpose of settling claims with insurance carrier. ... filing system. Process new insurance policies, modifications to existing policies, and claims forms. Obtain information from policyholders to verify the accuracy and… more
- J&J Family of Companies (Cherry Hill, NJ)
- …processes (ie, eligibility and benefit verification, pre-authorization, billing, coding, claims , and appeals /grievances); practice management; Medicare and ... searching for the best talent for Senior Area Business Specialist to be in South New Jersey. Territory includes:...a good match, you'll be invited to complete a short -recorded video interview, giving you the chance to share… more
- Modivcare (Charleston, WV)
- …be the right fit for you! Modivcare is looking for an experienced Exception Specialist III to join our team. This position is responsible for facilitating various ... accordance with procedural requirements. + Coordinates fair hearings and denial appeals , collaborating with stakeholders to resolve issues efficiently. + Manages… more
- Actalent (Chattanooga, TN)
- …providers, members, and member representatives regarding pharmacy prior authorizations, exceptions, and appeals . + Enter authorizations and test claims into the ... We are seeking a detail-oriented and customer-focused Pharmacy Support Specialist to join our team. In this role, you...Life & AD&D for the employee and dependents) * Short and long-term disability * Health Spending Account (HSA)… more
- Actalent (Chattanooga, TN)
- …providers and/or members/members representatives for pharmacy prior authorizations, exceptions, and appeals Enter authorizations and test claims into the ... * Life Insurance (Voluntary Life & AD&D for the employee and dependents) * Short and long-term disability * Health Spending Account (HSA) * Transportation benefits *… more
- Elevance Health (Chicago, IL)
- …Coding Auditor Principal** is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology, including case ... and per diem, generating highly complex audit findings recoverable claims for the benefit of the Company, for all...may be so complex and advanced that disputes or appeals may only be reviewed by other DRG Coding… more