• Appeals and Grievance Specialist

    Commonwealth Care Alliance (Boston, MA)
    …clinical, operations, pharmacy, dental, reporting, and member services. + Supports the Senior Appeals & Grievance Coordinator and A/G Coordinator in day-to-day ... 011540 CCA- Appeals & Grievances **Position Summary** Appeals and Grievances Specialist supports the Operations Department and the Appeals and Grievances… more
    Commonwealth Care Alliance (05/21/25)
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  • Inpatient Clinical & Coding Specialist

    Independent Health (Buffalo, NY)
    …that fosters growth, innovation and collaboration. **Overview** The Clinical & Coding Specialist - Senior will be responsible for reviewing coding and clinical ... They will aid in training other team members, evaluating appeals , and share audit trends across the team. Expertise...audit tips across the team. The Clinical & Coding Specialist - Senior will support the leadership in Hospital… more
    Independent Health (04/15/25)
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  • Senior Behavioral Health Peer…

    Sacramento County (Sacramento, CA)
    Senior Behavioral Health Peer Specialist Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/2979607) Apply  Senior Behavioral Health ... Street, Room 2640, Sacramento, CA 95814, telephone: ###. Such appeals must be filed within thirty (30) calendar days...best describes how you meet the minimum qualification for Senior Behavioral Health Peer Specialist . Current or… more
    Sacramento County (04/22/25)
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  • Senior Billing Specialist

    Akin Gump Strauss Hauer & Feld LLP (Houston, TX)
    …United States, Europe, Asia and the Middle East. We are currently seeking a Senior Billing Specialist in the Finance department, reporting to the Revenue ... ensuring that special billing arrangements are carried out. The Senior Billing Specialist is expected to perform...invoices pursuant to client requirement + Research rejections, handle appeals , and short pays and client payment disputes in… more
    Akin Gump Strauss Hauer & Feld LLP (05/10/25)
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  • Senior Billing Specialist

    Mount Sinai Health System (New York, NY)
    **Job Description** ** Senior Billing Specialist -Obstetrics and Gynecology Administration-Mount Sinai Beth Israel, 250 West 57th Street-Full Time, Days** The ... Senior Billing Specialist is responsible for multiple...and work missing charges, edits, denials list and process appeals . Posts denials in IDX on a timely basis.… more
    Mount Sinai Health System (06/04/25)
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  • Senior Accounts Receivable…

    SERV Behavioral Health System (Hamilton, NJ)
    …a wide range of services. JOB SUMMARY: Reporting to the Billing Manager, the Senior Accounts Receivable Specialist will be responsible for billing and submitting ... claims, and handling escalated billing and collection issues. The Senior Accounts receivable specialist serves as a...timeframe; + Identifies corrected claims and process all claim appeals ; + Ensures secondary billing is accurate and timely,… more
    SERV Behavioral Health System (05/09/25)
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  • Specialist -Accounts Receivable Follow…

    Baptist Memorial (Jackson, MS)
    Overview Job Summary The Accounts Receivable Follow Up Specialist performs all collection and follow up activities with third party payers to resolve all outstanding ... team efforts in the achievement of accounts receivable performance goals. The Specialist performs daily activities related to the successful closure of aged accounts… more
    Baptist Memorial (05/12/25)
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  • Senior Claim Benefit Specialist

    CVS Health (Tallahassee, FL)
    …Responsibilities** - Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise. - Applies medical necessity ... written inquiries related to requests for pre-approval/pre-authorization, reconsiderations, or appeals . - Insures all compliance requirements are satisfied and all… more
    CVS Health (06/07/25)
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  • Senior Employee and Labor Relations…

    Tufts Medicine (Boston, MA)
    …a variety of areas including employee discipline/corrective action and employee appeals and the grievance process. 2. Develops and modifies Employee Relations ... and able to interact with all levels of the organization ( senior management, clinical managers, physicians, etc.). 5. Strong written/verbal communication skills.… more
    Tufts Medicine (06/03/25)
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  • Senior Quality Specialist -Hybrid…

    CVS Health (Franklin, TN)
    …Responsibilities:** + Possesses knowledge all Aetna health products available to the senior market. + Gives guidance with sales inquiries + Manages various software ... including insurance plan types, PBM and major medical benefits, prior authorizations and appeals processing. + Ability to work in a fast paced environment, handling… more
    CVS Health (05/29/25)
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