• Appeals and Grievances Triage Administrator…

    Fallon Health (Worcester, MA)
    …information, visit fallonhealth.org. **Brief Summary of Purpose:** Fallon Health's (FH) Appeals and Grievance process is an essential function to FH's compliance ... other applicable regulatory requirements and member and provider expectations. The FH Appeals and Grievances Triage Administrator serves to administer the FH … more
    Fallon Health (03/26/25)
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  • Appeals & Grievance Analyst

    Point32Health (MA)
    …colleagues and communities. **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Member 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 (05/01/25)
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  • Tax Analyst - Audit and Appeals

    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
    Penske (03/07/25)
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  • TVC - Claims Benefit Advisor (Veterans…

    Texas Veterans Commission (Victoria, 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
    Texas Veterans Commission (04/24/25)
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  • Claims Resolution Representative

    University of Rochester (Rochester, NY)
    …expertise of the individual, and internal equity considerations._ **Responsibilities:** The Claims Resolution Representative II is responsible for working across ... collection. Responsibilities include but are not limited to researching, correcting, resubmitting claims , submitting appeals and taking timely and routine action… more
    University of Rochester (03/17/25)
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  • Patient Account Representative - Hospital…

    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
    Guidehouse (03/20/25)
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  • Accounts Receivable Claims

    Virtua Health (Mount Laurel, NJ)
    …insurances on a monthly basis and maintains records of declined claims requiring appeals .Position Qualifications Required / Experience Required:1-3 years ... codes, insurance information) and enters into database.Identifies and resolves denied claims , escalating accounts as necessary to ensure timely payment of … more
    Virtua Health (04/28/25)
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  • Patient Account Representative - Physician…

    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 (05/05/25)
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  • Claims Processor - Hybrid working…

    State of Colorado (Denver, CO)
    Claims Processor - Hybrid working arrangements Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4922602) Apply  Claims Processor - Hybrid ... Property Division, This position is responsible for processing owner claims according to the Revised Uniform Unclaimed Property Act...the official appeal form, signed by you or your representative . This form must be delivered to the State… more
    State of Colorado (04/29/25)
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  • Claims Consultant

    Archbright (Seattle, WA)
    …Lead in Making a Real Impact. Join Archbright as a Workers' Compensation Claims Consultant Are you an experienced workers' compensation professional with a passion ... name in workplace performance and compliance, is looking for a Workers' Compensation Claims Consultant to join our dedicated team. You'll be part of an organization… more
    Archbright (04/26/25)
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