- TEKsystems (Englewood, CO)
- Medical Appeals Specialist (Fully Remote) Make a measurable impact by overturning denials, recovering missed revenue, and improving patient account outcomes. As ... a Medical Appeals Specialist , you'll combine deep payer policy...claims and payer denial codes, plus hands‑on complex appeals workflows + EMR/EHR experience (ideally Epic and Athena;… more
- Fairview Health Services (St. Paul, MN)
- …critical research and timely and accurate actions including preparing and submitting appropriate appeals or re-billing of claims to resolve coding denials to ... **Job Overview** The Inpatient Coding Denials Specialist performs appropriate efforts to ensure receipt of...records and coding guidelines to formulate coding arguments for appeals and/or coding guidance for potential re-bills. Maintains a… more
- HCA Healthcare (Ocala, FL)
- …Do you have the career opportunities as a Clinical Denial Coding Review Specialist you want with your current employer? We have an exciting opportunity for ... Program (paid time off, paid family leave, long- and short -term disability coverage and leaves of absence) + Employee...want to work as a Clinical Denial Coding Review Specialist where your passion for creating positive patient interactions… more
- Helio Health Inc. (Syracuse, NY)
- …Maintains accurate files necessary for research and documentation. + Researches open claims and processes appeals when necessary. Follows up on patient ... support the mission of Helio Health, Inc., the Billing Specialist generates medical invoices, posts cash receipts, follows up...or concern arises. + Communicates insurance trends and unresolved appeals to the billing manager for further action. +… more
- AssistRx (Overland Park, KS)
- …how to expedite patient access + Document and initiate prior authorization process and claims appeals + Report any reimbursement trends or delays in coverage to ... A Day in the Life as a Patient Access Specialist : This role works directly with healthcare providers &...(PA) for an assigned caseload and helps navigate the appeals process to access medications. + Ensure cases move… more
- Cardinal Health (Denver, CO)
- …optimal account receivables performance and client satisfaction. + Resolves complex insurance claims , including appeals and denials, to ensure timely and ... appropriate. + Acts as a subject matter expert in claims processing. + Processes claims : investigates insurance...all Medicaid states on paper and online. + Oversees appeals and denials management to maximize revenue recovery and… more
- TEKsystems (Los Angeles, CA)
- Job Title: Retro Claims Reviewer Location: West Hills/Canoga Park 91305 Compensation: LVN $38-$40 hourly RN $45-$50 hourly Overview: The Retro Claims Reviewer is ... responsible for auditing and reviewing medical claims to ensure accuracy, regulatory compliance, and proper adjudication....Participate in special projects related to claim denials and appeals Required Qualifications: + Active LVN or RN license… more
- AssistRx (Maitland, FL)
- …how to expedite patient access + Document and initiate prior authorization process and claims appeals + Report any reimbursement trends or delays in coverage to ... coverage provided for a specific pharmaceutical product. The Patient Access Specialist will support the healthcare providers addressing questions regarding coding… more
- AssistRx (Maitland, FL)
- …how to expedite patient access + Document and initiate prior authorization process and claims appeals + Report any reimbursement trends or delays in coverage to ... provided for a specific pharmaceutical product. The Insurance Verification Specialist will support the healthcare providers addressing questions regarding coding… more
- CVS Health (Franklin, TN)
- …standards, and policies to provide effective and timely support. + Reviews pre-specified claims or claims that exceed specialist adjudication authority or ... **A Brief Overview** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with claim processing guidelines. **What you will do**… more