- Stanford Health Care (Palo Alto, CA)
- …underpayments to payers + Reviewing and resolving payer rejections, denials, and performing appeals as necessary + Electronic or hardcopy claims editing and ... Health Care job.** **A Brief Overview** The Patient Account Representative (PAR) is responsible for the timely and accurate...the timely and accurate processing of insurance balance patient claims in accordance with contracts and policies. The PAR… more
- AmeriHealth Caritas (Philadelphia, PA)
- …position is responsible for the administrative tasks for coordination of member and/or provider appeals , the analysis of claims and appeals , and the review ... medical management authorizations.; + Research and Investigate member and/or provider appeals and grievance requests, including review of UM/claim denial reasons,… 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
- Texas Veterans Commission (Houston, 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)
- **Job Family** **:** Patient Account Representative **Travel Required** **:** None **Clearance Required** **:** None **What You Will Do** **:** The **Patient Account ... Representative (PAR)** is expected to perform specific billing processes,...taking necessary actions to obtain account resolution + Submits appeals , as appropriate, for all non-clinical denials + Monitors… more
- Guidehouse (Lewisville, TX)
- **Job Family** **:** Patient Account Representative **Travel Required** **:** None **Clearance Required** **:** None **What You Will Do** **:** The **Insurance ... Patient Account Representative ** is an extension of a client's business office...from home._** **Essential Job Functions** + Account Review + Appeals & Denials + Medicare/Medicaid + Insurance Follow-up +… more
- Immigration and Customs Enforcement (Washington, DC)
- …ensure adherence to industry practices in eligibility verification, authorization of care, claims management denials and appeals to minimize adverse outcomes ... Summary The Claims Management Program Analyst supports the Health Plan...management program analyst lead when necessary. Serves as CMP representative between IHSC, third-party administrator, CBP components, and ICE… more
- The County of Los Angeles (Los Angeles, CA)
- …to match them with housing, and secure supportive services. + Prepares and submits appeals for claims that are denied, when justified. + Develops and submits ... VETERANS CLAIMS ASSISTANT II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/3989213) Apply VETERANS CLAIMS ASSISTANT II Salary $55,602.72… 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
- US Tech Solutions (Myrtle Beach, SC)
- … and completes adjustments and related reprocessing actions. Reviews and adjudicates claims and/or non-medical appeals . Determines whether to return, deny or ... according to department guidelines. **Responsibilities:** + Examines and processes claims and/or non-medical appeals according to business/contract regulations,… more
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