- TEKsystems (Portland, OR)
- Professional Summary: The Appeals Specialist I is responsible for managing provider billing disputes and appeals with precision and professionalism. This ... policies. While not responsible for making final clinical decisions, the Appeals Specialist I works closely with licensed health professionals to support… more
- Cognizant (Salem, OR)
- ** 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
- CVS Health (Salem, OR)
- …**Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise. - Applies medical ... written inquiries related to requests for pre-approval/pre-authorization, reconsiderations, or appeals . - Ensures all compliance requirements are satisfied and all… more
- Intermountain Health (Salem, OR)
- …providers, clinical staff, compliance and the CDI team. + Audits and creates appeals for all payer and regulatory denials and downgrades and provides in-depth coding ... review, audit findings, and appeal strategies. + Develops and implements training plans for all internal stakeholders including coders at all levels, providers, clinical staff, compliance and the CDI team. + Audits clinical documentation and coding for complex… more
- Robert Half Accountemps (Eugene, OR)
- Description We are looking for a detail-oriented Medical Biller/Collections Specialist to join our team in Eugene, Oregon. In this contract role, you will play a ... * Proven experience in medical billing, including collections, denials, and appeals . * Familiarity with hospital billing practices and medical terminology. *… more
- Cardinal Health (Salem, OR)
- …skills and prioritizes getting the right things done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will ... the appropriate system. + Manages and resolves complex insurance claims, including appeals and denials, to ensure timely and accurate reimbursement. + Processes… more
- Evolent (Salem, OR)
- …Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional cardiology to help ensure the ... of best practices. + Provides clinical rationale for standard and expedited appeals . + Discusses determinations (peer to peer phone calls) with requesting physicians… more