- Equitable (Charlotte, NC)
- Appeals Specialist , Disability Claims ( 25000066 ) **Primary Location** : UNITED STATES-NC-Charlotte **Other Locations** : UNITED STATES-Remote, UNITED ... help unlock your potential? Equitable is seeking an influential and dynamic Appeals Specialist to join our Disability and Absence Claims organization. The … more
- TEKsystems (Charlotte, NC)
- …1. Manages workflow for Humana PPI Audits, RAC Audits, or outpatient appeals and communicates daily with Sr. Director/Manager on trends identified 2. Respond ... effectively move through the revenue cycle 4. Completes claim appeals and assists with other projects as needed 5....accounts by following HIPPA guidelines Additional Skills & Qualifications Appeals and denials medical claims medical appeals … more
- North Carolina State University (Raleigh, NC)
- …UTS/UNC Partnership Location: Chapel Hill, NC Essential Job Duties: This Insurance Specialist position offers both dental and medical insurance services . The ... Insurance Specialist works in all areas of billing and reimbursement,...denied claims, following up on those investigations, and submitting appeals for those denied claims; + Verifying essential documentation… more
- UNC Health Care (Raleigh, NC)
- …the Health Care System at each of the four levels of appeals when applications are denied. **Responsibilities:** 1. Obtains detailed personal, financial and ... Medicaid offices to obtain reversal of initial denial. Abstracts information, prepares appeals and represents UNC Health Care System in appeal hearings at local,… more
- Intermountain Health (Raleigh, NC)
- **Job Description:** The Pre-Access Authorization Specialist I is responsible for accurately verifying and completing insurance eligibility, securing prior ... pertinent patient related insurance eligibility, benefits, authorization; follow-up on appeals and denials when requested + Contacts patient/provider when… more
- UNC Health Care (Goldsboro, NC)
- …of the unique communities we serve. Summary: The Medicaid Eligibility Specialist screens, coordinates and facilitates the Medicaid application process across ... and conduct of administrative and/or judicial, local and up to State appeals . 7. Gathers and provides necessary verification to establish Medicaid eligibility via… more
- KPH Healthcare Services, Inc. (Greensboro, NC)
- **Overview** The Revenue Cycle Management Specialist - Collections responsibility is to ensure timely collection of outstanding balances. **Responsibilities** + ... complex or uncollectible accounts to management for further action. + Submit appeals /claim corrections as needed within timely filing limits. + Utilize billing… more
- CaroMont Health (Gastonia, NC)
- …departments and committees. Assist with retrospective reviews and preparation of appeals as indicated. Facilitate peer review activities and integrate review ... findings with the credentialing and reappointment process as needed. Working closely and having frequent communication with Service Line Medical Directors, Service Line Directors, and Department Heads will be required. Frequent communication and updates with… more
- Elevance Health (Winston Salem, NC)
- …TRICARE methodology and findings may be so complex and advanced that disputes or appeals may only be reviewed by other DRG Coding Audit Principals (or Executives). ... as a Registered Health Information Technician, CCS as a Certified Coding Specialist , CIC as a Certified Inpatient Coder, or Certified Clinical Documentation … more
- Novant Health (Winston Salem, NC)
- …of processes such as petitioning for guardianship and navigating the Medicare appeals process. + Willingness to cross train between Inpatient and Emergency ... required. + For the Substance Use Therapist role, Licensed Clinical Addiction Specialist or Licensed Clinical Addiction Specialist Associate. This specific… more
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