- MCKESSON (Baltimore, MD)
- …reimbursement challenges for a specific drug (including Benefit Investigation, Prior Authorization, Claims Assistance, and Appeals ) and educating the office on ... Support on Case management, billing and coding updates, appropriate claims submission, Specialty Pharmacy, Medical Benefit Interpretation, understanding medical… more
- Point32Health (FL)
- …(https://www.point32health.org/) . **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Appeals and Grievance Analyst ... the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual works… more
- Point32Health (Canton, MA)
- …(https://www.point32health.org/) . **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Member Appeals and Grievance ... the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual works… 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
- Ochsner Health (New Orleans, LA)
- …make a difference at Ochsner Health and discover your future today!** The Appeals Specialist is responsible for managing and resolving insurance claim denials and ... **Job Duties** + Review and analyze denied or underpaid claims to determine appeal opportunities. + Prepare and submit...staff and coding teams to obtain necessary documentation for appeals + Track and monitor appeal status, maintaining detailed… more
- Texas Veterans Commission (Borger, 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 (El Segundo, CA)
- …Required** **:** None **What You Will Do** **:** The **Insurance Patient Account Representative ** **(Hospital Claims )** is an extension of a client's business ... and three days from home._** **Essential Job Functions** + Account Review + Appeals & Denials + Medicare/Medicaid + Insurance Follow-up + Customer Service + Billing… more
- Kelly Services (Myrtle Beach, SC)
- …Great opportunities are right here in your backyard. Kelly(R) is looking for a Claims Customer Service Representative to work at a premier organization in Myrtle ... - $23 Why you should apply to be a Claims Customer Service Representative : + Competitive pay...written, web, or walk-in inquiries. + Reviewing and adjudicating claims and/or non-medical appeals , determining whether to… more
- Mendocino County Sheriff's Office (Ukiah, CA)
- …Must obtain accreditation by the California Department of Veterans Affairs as a Claims Representative in accordance with Title 38 Code of Federal Regulations ... such as military, medical, and legal records. + Prepares, submits, and monitors claims and appeals through appropriate federal, state, and local channels,… more
- Insight Global (Nottingham, MD)
- …diploma or equivalent * Outpatient hospital billing experience * Experience with facility claims follow-up & appeals handling o Experience with UB04 forms o ... is looking for an Outpatient Facility Claim Follow Up Representative to support a large hospital system in the...corrective actions with payers. This team focuses on facility claims only, and this role is focused only on… more
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