- TEKsystems (Denver, 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...or Sick Leave) Workplace Type This is a fully remote position. Application Deadline This position is anticipated to… more
- CareFirst (Baltimore, MD)
- …without breaching confidentiality of medical information. + Assists Supervisor and Appeals Specialist II and III with unit projects and other duties ... **Resp & Qualifications** **PURPOSE:** The Appeals Specialist I is responsible for...Skills and Abilities (KSAs)** + Knowledge and understanding of medical terminology. + Demonstrated problem solving and decision-making skills,… more
- Community Health Systems (Franklin, TN)
- …and supports initiatives that improve denial prevention and recovery processes. As an Appeals Specialist II at Community Health Systems (CHS) - SSC Nashville, ... **Job Summary** The Appeal Specialist II reviews, analyzes, and resolves insurance denials...Our team members enjoy a robust benefits package including medical , dental and vision, insurance, and 401k. **Essential Functions**… 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
- 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
- CommonSpirit Health (Centennial, CO)
- …you flourish and leaders who care about your success. The RN Clinical Denials Appeals Specialist functions as a revenue management liaison for all care sites ... external third-party payers to appeal denied claims and retrospectively identifies appeals determination as indicated through research and coordination of completion… 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
- 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 ... with CMS requirements, guidelines, and standardized published criteria to support the medical necessity of patient admission and continued hospital stays. This role… more
- Northwell Health (Melville, NY)
- …the third party payer. + Prepares and defends level of care and medical necessity for assigned case. + Collaborates with physician advisor, payor representative and ... + Performs concurrent and retrospective utilization management using evidenced-based medical necessity criteria; conducts clinical reviews and formulates appeal… more
- Ochsner Health (New Orleans, LA)
- …make a difference at Ochsner Health and discover your future today!** The Appeals Specialist is responsible for managing and resolving insurance claim denials ... underpayments to ensure accurate reimbursement. This role involves reviewing medical documentation, interpreting payer policies, and preparing detailed appeal… more