- Munson Healthcare (Traverse City, MI)
- …five (5) years' experience in a revenue cycle role (billing, registration, insurance verification, referral coordinator, etc) . Ability to work independently and ... of Utilization Management and works closely with the Utilization Management and Appeals team . Interacts independently with all Munson Health Care departments.… more
- Point32Health (RI)
- …as a customer service or member services representative in health care or insurance + Preferred: 2 years' Appeals and Grievance experience **Skill Requirements** ... **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Appeals and...NCQA (National Committee for Quality Assurance), DOI (Dept of Insurance ), CMS, DOL and any state or federal specific… more
- AscellaHealth (Berwyn, PA)
- …manages the process of receiving, researching, and resolving prior authorizations and appeals issues with health insurance companies, including any escalated ... What we are looking for Optime Care seeks a Prior Authorization and Appeals Specialist for our Berwyn, PA location. We are looking for someone who is passionate… more
- Mount Sinai Health System (New York, NY)
- …in the department as per protocol + Requests or provides Medical Records as required for appeals , On / Off-site Insurance reviews + Implements first step of ... information in Allscripts + Meets time frame for reviews / appeals as specified by Insurance / State & Federal regulation. + Enters concurrent review information… more
- Whidbey General Hospital (Coupeville, WA)
- …refunds, and audits. + Inputs statistically numbers in online reports. + Prepares insurance appeals and follows up as required. + Processes technical denials. ... responsible for coordinating patient referrals and subsequent follow up, verifying insurance and providing financial counseling to assist with self-pay accounts, as… more
- University of Virginia (Charlottesville, VA)
- …has assigned AR responsibility. + Performs inpatient/outpatient follow up and working insurance denials, appeals claims as defined by payer and departmental ... The Central Billing Office (CBO) Insurance Resolution Specialist handles and resolves all Insurance billing follow up and denial issues to ensure all facilities… more
- Beth Israel Lahey Health (Cambridge, MA)
- …writing skills to prepare various reports to state and federal regulators, insurance appeals , internal correspondence, and clinical summaries for medical peer ... of care. Applies knowledge of disease and nursing processes to write effective appeals and clinical abstracts, identifies quality of care and risk management issues.… more
- UNC Health Care (Chapel Hill, NC)
- …to coder questions and provide training and education. This position processes and appeals insurance coding denials. This position analyzes coded records for ... the coding and send for rebilling if required. 5. Generate coding appeals for insurance denials with sound arguments and based on coding guidelines and… more
- Guthrie (Sayre, PA)
- …as well as identifies, analyzes and takes the necessary action to submit complex appeals to insurance payers. Reviews all medical chart and account documentation ... to determine appropriate coding and initiate corrected claims and appeals . Interprets payer guidelines, regulatory guidelines, contractual obligations and works… more
- Johns Hopkins University (Middle River, MD)
- …data for conclusive thought. + Demonstrated experience resolving third-party payor insurance processing issues, including appeals and denials. **Minimum ... the collection of unpaid third-party claims and independent resolution of complex appeals , using various JHM applications and JHU/ PBS billing applications. Will… more