- HCA Healthcare (Pasadena, TX)
- …Do you want to join an organization that invests in you as a Medical Insurance Claims Appeals Representative ? At Parallon, you come first. HCA Healthcare has ... the opportunity to make a difference. We are looking for a dedicated Medical Insurance Claims Appeals Representative like you to be a part of our team. **Job… more
- Point32Health (Watertown, MA)
- …colleagues and communities. **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Appeals and Grievance Analyst is ... the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual works… more
- LA Care Health Plan (Los Angeles, CA)
- Manager, Customer Solution Center Appeals and Grievances Job Category: Management/Executive Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, ... to achieve that purpose. Job Summary The Manager, Customer Solution Center Appeals and Grievances is responsible for the centralized intake, logging and triage… more
- St. Luke's University Health Network (Allentown, PA)
- …of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding ... determination made by the government or commercial payors, or their auditor representative . + Facilitate clinical chart reviews to assist with supporting assigned… more
- St. Luke's University Health Network (Allentown, PA)
- …regardless of a patient's ability to pay for health care. The Coding Appeals Specialist retrospectively reviews patient medical records, claims data and coding ... AMA CPT, are assigned to support the services/treatment rendered. The Coding Appeals Specialist also prepares appeal arguments and/or letters to support and defend… more
- Penske (Reading, PA)
- …audits, including negotiating with auditors and interfacing with taxing jurisdictions. -Perfect appeals and refund claims . -The position will require the ability ... are required. **Physical Requirements:** -The physical and mental demands described here are representative of those that must be met by an associate to successfully… more
- Robert Half Accountemps (Olathe, KS)
- Description We are offering a contract to hire employment opportunity for a Medical Claims Representative in Olathe, Kansas. This role is within the industry of ... the Representative to handle various responsibilities related to medical claims , insurance, and billing functions. Responsibilities: * Handle medical claims … more
- Texas Veterans Commission (Midland, TX)
- …rulings, and state law in the adjudication process. . Prepares and files claims and appeals with supporting evidence for successful adjudication. . Advises ... Financial Operations* **Organization:** **TEXAS VETERANS COMMISSION* **Title:** *TVC - Claims Benefit Advisor (Veterans Services Representative I)* **Location:**… more
- Guidehouse (Lewisville, TX)
- …San Antonio office and three days from home._** **Essential Job Functions** + Hospital Claims + Account Review + Appeals & Denials + Medicare/Medicaid + ... **Job Family** **:** Patient Account Representative **Travel Required** **:** None **Clearance Required** **:**...+ 1+ year's medical provider experience working with UB04, appeals & denials. + Hospital or EOB claims… more
- US Tech Solutions (Myrtle Beach, SC)
- …equivalent. + Required Work Experience: 2 years of customer service experience including 1-year claims or appeals processing OR Bachelor's Degree in lieu of work ... Performs research as needed to resolve inquiries. Reviews and adjudicates claims and/or non-medical appeals . Determines whether to return, deny or pay claims … more
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