- Northwell Health (Melville, NY)
- …medical necessity for assigned case. + Collaborates with physician advisor, payor representative and site case managers to facilitate appropriate level of care ... current state, federal, and third-party payer regulations. Ensures clinical reviews and appeals are up to date and accurately reflect patient's severity of illness… more
- Rochester Regional Health (Rochester, NY)
- JOB TITLE: Collections and Denials Management Representative LOCATION: SLH DEPARTMENT: Patient Financial Services Hours: 37.5 SCHEDULE: Monday-Friday 8AM-4PM ... SUMMARY: A Medical Billing and Denials Specialist is responsible for managing the billing process,...accurate account resolution in line with payer requirements. + Appeals & Reimbursement Review: Conduct detailed reviews of denied… 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 ... + Experience in healthcare or revenue cycle - specifically insurance claim denials . + Strong analytical and organizational skills. + Excellent communication and… more
- St. Luke's University Health Network (Allentown, PA)
- …needed for workflow or identification of trends. Assists in preparing reports regarding denials to include volumes, number of appeals , case resolution, and ... a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all… more
- Insight Global (Nottingham, MD)
- …resolving underpayments, denials , and contract interpretation issues-not clinical denials or patient balances. The representative ensures accurate ... Description Insight Global is looking for an Outpatient Facility Claim Follow Up Representative to support a large hospital system in the Maryland/DC area. This… more
- Beth Israel Lahey Health (Charlestown, MA)
- …lives.** Identifies, reviews, and interprets third party payments, adjustments, and denials . Initiates corrected claims, appeals and analyzes unresolved third ... the Supervisor, Billing with the resolution of complex claims issues, denials , appeals and credits. 18. Completes projects and research as assigned. **Minimum… more
- Guidehouse (Birmingham, AL)
- …all denials taking necessary actions to obtain account resolution. + Submits appeals , as appropriate, for all non-clinical denials + Monitors all denials ... **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,… more
- Guidehouse (San Marcos, CA)
- …from home._** **Essential Job Functions** + Hospital Claims + Account Review + Appeals & Denials + Medicare/Medicaid + Insurance Follow-up + Customer Service ... **Job Family** **:** Patient Account Representative **Travel Required** **:** None **Clearance Required** **:**...+ 1+ year's medical provider experience working with UB04, appeals & denials . + Hospital or EOB… more
- TEKsystems (Farmington, CT)
- Insurance Follow‑Up Representative (Hybrid) Shift: 7:30 am - 4:00 pm Employment Type: Full-Time Schedule: Monday - Friday Pay Rate: $25-27/HR Hybrid Schedule (After ... A leading academic health system is seeking an experienced Insurance Follow‑Up Representative to support its hospital billing operations. This role focuses on… more
- New York State Civil Service (Albany, NY)
- …Yes Agency Attorney General, Office of the Title Senior Consumer Frauds Representative or Consumer Frauds Representative Trainee (NY HELPS) Occupational Category ... including, but not limited to billing and claims reimbursement disputes; denials of coverage for medical treatment, prescriptions, and medical devices; incorrect… more