- TEKsystems (Dallas, TX)
- 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
- Molina Healthcare (Dallas, TX)
- …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 (Dallas, TX)
- …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
- Molina Healthcare (Dallas, TX)
- **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
- Urology Clinics of North Texas (Mesquite, TX)
- AR SPECIALIST Job Details Job Location 1650 Republic Pkwy Ste 150, Mesquite, TX 75150 - Mesquite, TX Position Type Full Time Education Level High School Travel ... for a customer-focused office professional to perform collections, filing claims, handle appeals , and correspondence with payers. This position will focus on claims… more
- HCA Healthcare (Dallas, TX)
- …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 (Dallas, TX)
- …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
- Robert Half Finance & Accounting (Dallas, TX)
- Description Billing Specialist Overview: The Billing Specialist plays a critical role in ensuring the seamless execution of billing processes, compliance with ... billing, and preparing e-bills. Analyze and monitor e-billing platforms to handle appeals for deductions and specialty legal billing issues. Submit invoices via… more
- Methodist Health System (Dallas, TX)
- …**Your Job:** We are seeking an experienced Accounts Receivable II (AR II) Specialist specializing in Professional Billing for Family Practice to join our team in ... claims, denied claims, and correspondence. As an AR II Specialist , you will play a crucial role in optimizing...actions based on correspondence received, such as claim corrections, appeals , or adjustments. - Conduct thorough follow-up on aging… more
- Adecco US, Inc. (Irving, TX)
- …barriers. + Manage benefit investigations, prior authorizations, claims escalations, and appeals . + Deliver payer insights and education on Medicare and commercial ... pharmacy. + Experience with prior authorizations, claims processing, and appeals . + Strong communication, presentation, and organizational skills with customer… more