- TEKsystems (Atlanta, GA)
- Overview We are seeking a highly analytical and proactive Revenue Cycle Appeals Specialist to join our team. This role is ideal for someone with strong ... experience in appeals , denials, and insurance follow-up within the healthcare revenue...cause analysis to determine next steps. 2. Rebilling & Appeals Submission + Focus on claims ready for appeal-already… more
- Cognizant (Atlanta, GA)
- ** Appeals & Grievance Specialist (remote)** This is a remote position open to any qualified applicant in the United States. **Job Summary:** We are seeking a ... dedicated Appeals & Grievance Specialist with 2 to 3 years of experience to join our team. The ideal candidate will have strong technical skills in MS Excel and… more
- Molina Healthcare (Augusta, GA)
- …for letters and prepare responses to appeals and grievances. + Elevates appropriate appeals to the Appeals Specialist . + Generates and mails denial ... systems and other available resources. + Assures timeliness and appropriateness of appeals according to state and federal and Molina Healthcare guidelines. +… more
- Molina Healthcare (Atlanta, GA)
- …hours** Must be able to rotate weekends and holidays** Must have Medicare Appeals and IRE experience** Responsible for reviewing and resolving member and provider ... + Responsible for the comprehensive research and resolution of the appeals , dispute, grievances, and/or complaints from Molina members, providers and related… more
- Healthfirst (GA)
- …Reduction, Termination, and Suspension of services. The end-to-end process requires the Specialist to independently: + Research issues + Quality of Care Experience + ... + Work within a framework that measures productivity and quality for each Specialist against expectations + Prepare cases for Medical Director Review ensuring that… more
- Molina Healthcare (Savannah, GA)
- **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and correct clinical decisions for appeals outcomes within compliance ... standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical/medical reviews of previously denied cases in which a formal appeals… more
- State of Georgia (Fulton County, GA)
- …Georgia Department of Labor is accepting applications to fill the Central Office Specialist position in the UI Appeals Department located at Georgia Department ... Central Office Specialist - TLB Georgia - Fulton - Atlanta...availability. ESSENTIAL FUNCTION & RESPONSIBILITIES Receives, investigates and processes appeals submitted via mail, fax, email and online accordingly… more
- Nobis Works (Atlanta, GA)
- Job Descriptions: Position Summary: The Development Specialist is an integral part of the Development team's innovation and execution by serving an active support ... Plan that incorporates a range of strategies, including annual appeals , grants, corporate and major donor appeals ,...accepting vehicle donations both online and in person. The specialist will resolve or help to resolve any vehicle… more
- HCA Healthcare (Augusta, GA)
- …local, state and federal agencies and accrediting bodies. The Inpatient Coding Denials Specialist must ensure timely, accurate, and thorough appeals for all ... that invests in you as an Inpatient Coding Denials Specialist ? At Parallon, you come first. HCA Healthcare has...We are looking for a dedicated Inpatient Coding Denials Specialist like you to be a part of our… more
- Molina Healthcare (Atlanta, GA)
- …Member issues in areas involving member impact and engagement including: Appeals and Grievances, Member Problem Research and Resolution, and the ... analyses of advocacy issues; and assists with documentation preparation for appeals , fair hearings or other formal/informal dispute resolution process. * Provides… more
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