- Your Behavioral Health (Torrance, CA)
- …seeking a detail-oriented, proactive Utilization Review (UR) Coordinator to support insurance authorization processes across all levels of care - including Detox, ... clinical teams and payors to advocate for clients, secure appropriate insurance authorizations, and support a smooth treatment experience. Key Responsibilities: … more
- Covenant Health Inc. (Knoxville, TN)
- Overview Insurance Appeals Senior , Revenue Integrity and Utilization Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is ... integrity auditor to take appropriate action. Prepares necessary documentation for insurance appeals process, ensuring timely follow through. Processes claim… more
- TEKsystems (Addison, TX)
- …processes, claim adjudication, and reimbursement methodologies. - Familiarity with insurance denials, appeals , and arbitration processes, including knowledge ... identify the root causes. - Initiate and manage the appeals and arbitration process for denied or underpaid claims,...- Pre-tax and Roth post-tax contributions available * Life Insurance (Voluntary Life & AD&D for the employee and… more
- Point32Health (FL)
- …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
- Logan Health (Kalispell, MT)
- … denials processing as applicable to assigned area(s). + Responsible for all insurance appeals and works with appropriate stakeholders to ensure completion as ... strong critical thinking skills and an in-depth understanding of insurance eligibility, payment methodologies, and contractual adjustments based on government… more
- University of Virginia (Charlottesville, VA)
- …Office 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
- Guthrie (Sayre, PA)
- …within the unit. Takes the necessary action to complete all types of complex insurance billings and appeals . Reviews and analyzes the insurance processing ... Position Summary: Fulfills all requirements of Insurance Specialist I, as well as serving as...skills and proficiency in analyzing complex billing problems, prepares appeals , challenges payer policies and pursues appeal turnover when… more
- Insight Global (Nottingham, MD)
- …system in the Maryland/DC area. This person will be overseeing and managing the insurance denial and appeals process to minimize financial risk and improve ... to medical necessity and assess the feasibility of submitting appeals . * Draft medical summaries of denied cases for...for escalation to legal or regulatory bodies (eg, Maryland Insurance Administration) when necessary. * Identify root causes and… more
- LA Care Health Plan (Los Angeles, CA)
- Registered Nurse (RN) Manager, Appeals and Grievances General Operations (Clinical) Job Category: Clinical Department: CSC Appeals & Grievances Location: Los ... the safety net required to achieve that purpose. Job Summary The Manager, Appeals & Grievances (A&G) & General Operations (Clinical) is responsible for the daily… more
- BronxCare Health System (Bronx, NY)
- Overview The Appeals Manager is responsible to assist in the analysis and preparation of response to denial notification letters that arrive in letter and electronic ... format. Collaborating with the Department Denial and Appeals Coordinators, Physician Advisors, and the clinical staff, the Appeal Manager is responsible to develop a… more
