- 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...or Sick Leave) Workplace Type This is a fully remote position. Application Deadline This position is anticipated to… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Appeals Specialist I is responsible for the initial analysis of appeals and/or grievance correspondence, and ... without breaching confidentiality of medical information. + Assists Supervisor and Appeals Specialist II and III with unit projects and other duties related… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist I (Temporary) Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los ... safety net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Specialist I primary function is to learn the… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II (Temporary) Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los ... net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve… more
- AmeriHealth Caritas (Philadelphia, PA)
- …. **This position is hybrid in Philadelphia, PA** **Job Summary** The Appeals & Grievance Case Resolution Specialist is responsible for the ... full life cycle of assigned member and/or provider appeals and grievance cases. Working under general supervision, this role conducts case intake, investigation, and… more
- Scripps Health (San Diego, CA)
- …**Job:** **Business Office* **Organization:** **Scripps Health Corp* **Title:** *Public Resource Specialist - Programs & Appeals * **Location:** *Central San ... schedule, located at Scripps Mercy Hospital Chula Vista (one remote day per week once training is complete). You...Scripps Mercy Hospital Chula Vista as a Public Resource Specialist . In this position, you will be responsible for… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Denials & Appeals Coordinator is responsible for managing, tracking, and resolving denials and appeals to ensure timely reimbursement. This ... all follow-up dates are current. + Analyzes denials to determine appropriate actions, completes appeals , or routes cases for clinical appeals as needed. + Files… more
- Robert Half Legal (Mountlake Terrace, WA)
- …Robert Half is partnering with a Healthcare Organization searching for their next appeals specialist . This is an excellent opportunity for a motivated ... a fast-paced environment. They are looking for someone to join ASAP! Location: Remote Pay Rate: $21-23 per hour Duration: 3+ months potential for extension Schedule:… more
- Northwell Health (Melville, NY)
- …current state, federal, and third-party payer regulations. Ensures clinical reviews and appeals are up to date and accurately reflect patient's severity of illness ... + Must have experience with Milliman Care Guidelines and/or InterQual. Hours/Shift + Fully remote role + Days: Sunday - Thursday + Hours: 8:00am - 4:00pm *Additional… more
- Nuvance Health (Danbury, CT)
- *Description* *FULL TIME DAY SHIFTS- VARIABLE HOURS / WEEKEND ROTATIONS REQUIRED* * *Hybrid/ Remote * * *Summary:* The purpose of the Denial Prevention Nurse is to ... 44, MOON, Connecticut notice of conversion, etc. * Tracking and trending all appeals and communicating on a daily/regular basis with the Denials Management team. *… more