- 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)
- …The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all diagnosis and procedure codes to ... determination made by the government or commercial payors, or their auditor representative . + Facilitate clinical chart reviews to assist with supporting assigned… more
- Sanford Health (ND)
- …40.00 **Salary Range:** $15.00 - $22.00 **Job Summary** The Insurance Representative processes and monitors unpaid third party insurance, Medicare, Medicaid or ... to work accounts throughout the entire revenue cycle. Prepares and submits claims to payers either electronically or by paper. Secures necessary medical… more
- Rush University Medical Center (Chicago, IL)
- …liability carriers and attorneys representing the patients. + Following up on outstanding claims , including timely appeals for denied or rejected claims . ... experience and skills, as well as internal equity and industry specific market data . The pay range for each role reflects Rush's anticipated wage or salary… more
- 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
- US Anesthesia Partners (Austin, TX)
- …without a reasonable accommodation) + Contacts insurance companies for status on outstanding claims . + Processes and follows up on appeals to insurance ... Overview The Accounts Receivable Representative III is responsible for collecting outstanding accounts...Provides peer payer and system training support. + Gathers data and reports out in partnership with leadership. +… more
- Owens & Minor (Columbus, OH)
- …The collections representative follows-up with insurance companies to resolve unpaid claims . The anticipated hourly range for this position is $12.21 - $17.04. ... 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
- US Anesthesia Partners (Austin, TX)
- …without a reasonable accommodation) + Contacts insurance companies for status on outstanding claims . + Process and follow up on appeals to insurance companies. ... Overview The Accounts Receivable Representative I is responsible for collecting outstanding accounts...Knowledge of managed care, Medicare, and Medicaid guidelines. + Data entry skills with high accuracy. + Knowledge of… more
- Insight Global (Greenwood Village, CO)
- …* Review patient account details including demographics, insurance coverage, and billing data prior to claim submission * Submit claims to insurance ... * Investigate and resolve claim denials through re-billing, corrected claims , or appeals * Document all activities...resolve billing issues * Ensure compliance with HIPAA and data security protocols We are a company committed to… more
- CVS Health (Frankfort, KY)
- …are handled within a timely manner. Staff may be responsible for reviewing claims data and information. The Senior Network Relations Analyst is responsible ... + Oversees Access & Availability monthly monitoring process. + Responsible for reviewing claims data in QNXT when provider's inquiry involves claims … more
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