- AmeriHealth Caritas (Newark, DE)
- …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
- 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)
- …health care. The Coding Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all diagnosis and procedure codes to ... 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
- Kelly Services (Glastonbury, CT)
- …terminology to process claims accurately. + Process and adjust medical claims and appeals according to established policies and procedures. + Prepare ... **Job Title:** **Medical Claims Account Manager** **Reports To:** CFO **FLSA Status:**...(SLAs). **Essential Duties and Responsibilities** _The following duties are representative of the role. Other duties may be assigned… more
- UNC Health Care (Chapel Hill, NC)
- …**Job Responsibilities:** + Responsible for the accurate and timely submission of claims follow up, reconsideration and appeals , response to denials, and ... payer, system or escalated account issues. + May maintain data tables for systems that support PB Claims... data tables for systems that support PB Claims operations. + Evaluate carrier and departmental information and… more
- Access Dubuque (Dubuque, IA)
- Member Services Representative **Medical Associates** 1 Positions ID: ol9qxfwb Posted On 08/26/2025 **Job Overview** **Description** If you are looking for a ... Health Plans is looking for a **full-time Member Services Representative ** to join our team! **Who You Are:** +...employee benefit plans offered + Interpret and enter necessary data and documentation into member and authorization subsystems of… more
- TEKsystems (Chicago, IL)
- …insurance information, and resolve recoupment issues + Access payer websites to gather data and resolve claims + Communicate system access issues, payor trends, ... are seeking a highly skilled and detail-oriented Patient Account Representative to join our Revenue Cycle team. This role...of medical collections experience including working with denials and appeals + UB-04/hospital claims experience + EPIC… more
- Owens & Minor (Kansas City, KS)
- …The collections representative follows-up with insurance companies to resolve unpaid claims . The anticipated hourly range for this position is $10.99 - $17.70. ... customers on delinquent payments. + Reviews unpaid and underpaid claims . Resubmits or appeals as necessary. +...a strong ability to understand, interpret and develop spreadsheet data . **Other Skills** **PHYSICAL DEMANDS** This is a stationary… more
- SSM Health (MO)
- …and payment rules. Bills claims appropriately. + Follows up on denied claims by performing appeals and denial recovery procedures. Works denied claim lines ... or more of the following: processing insurance payments, following up on denied claims , and resolving credit balances. Typically works in no more than two functional… more
- WellSpan Health (Chambersburg, PA)
- …and maintains accuracy, integrity, and completeness in all records, reports, and claims issued in conjunction with responsibilities. 3. Prioritizes workload at the ... accordance with department policy. Takes complete phone messages to include caller data and response requested. Displays proper telephone etiquette and respect for… more
Related Job Searches:
Appeals,
Appeals Representative,
Claims,
Claims Appeals Representative,
Data,
Representative