- Humana (Richmond, VA)
- …a part of our caring community and help us put health first** The Appeals Representative 4 Investigates and resolves member and practitioner issues. manages ... determine if an a grievance, appeal or further request is warranted. The Appeals Representative 4 + Review documents + Building cases + Inventory Management +… more
- Executive Office for US Attorneys and the Office of the US… (Newport News, VA)
- …an opportunity to work on their own caseload and handle their own trials and appeals as a representative of the United States. This office is hiring for ... part of a dedicated team helping to prosecute federal criminal cases and prepare appeals in the Major Crimes Unit. This Unit investigates and prosecutes a wide… more
- Intermountain Health (Richmond, VA)
- …such as debits/credits, required + Experience with insurance claim appeals , required + Excellent computer skills (including Microsoft Office applications), ... required- Familiarity with electronic remittances, required **Physical Requirements** + Interact with others by effectively communicating, both orally and in writing + Operate computers and other office equipment requiring the ability to move fingers and hands… more
- Cardinal Health (Richmond, VA)
- …the appropriate system. + Manages and resolves complex insurance claims, including appeals and denials, to ensure timely and accurate reimbursement. + Processes ... denials & rejections for re-submission (billing) in accordance with company policy, regulations, or third-party policy. + More challenging claim cases + Investigates and updates the system with all information received from secondary insurance companies. +… more
- Highmark Health (Richmond, VA)
- …of benefit billing practices through paid clams review. + Participate as pharmacy representative in onsite member appeals and grievances sessions. + Serve as ... a resource for technical staff. + Other duties as assigned or requested. **QUALIFICATIONS:** **Minimum** + High school diploma or GED + Experience in pharmacy prescription claims processing/submission/payment. **Preferred** + Associate degree + Pharmacy… more
- GAP Solutions Inc (Arlington, VA)
- …of Defense Consolidated Adjudications Facility (CAF), the Navy Personal Security Appeals Board (PSAB), Air Force PSAB, WHS Correspondence Analysis Branch (CAB), ... + Making classified courier runs as required, + Supports security administration in DISS- Appeals . + Assist with physical and personnel security needs as required, +… more
- Highmark Health (Richmond, VA)
- …correspondence inquiries (routine, priority Congressional / Department of Defense), and appeals . Ensures that all processes are compliant with requirements and ... Provides direction for priority Congressional and Department of Defense inquiries and appeals . + Performs administration tasks such as leave approvals and functions… more
- University of Virginia (Charlottesville, VA)
- …and followed up to meet the CBO Revenue Cycle performance metrics & representative Facility specific goals. They will also research and answer all questions and ... center with the highest degree of courtesy and professionalism. The representative utilizes multiple electronic billing, hospital information systems and payer… more
- Intermountain Health (Richmond, VA)
- …updates to charging/coding/NCCI regulations and/or errors, and regarding audits and appeals , to facilitate corrective action planning for improved processes. 7. ... experience leading others or leading project or programs. Certified Revenue Cycle Representative (CRCR) Certification completed within 3 months of hire. Plus one of… more
- Cardinal Health (Richmond, VA)
- …insurance plan coverage, including out-of-pocket costs, and provide guidance on the appeals process if needed + Resolve patient's questions and any representative ... for the patient's concerns regarding status of their request for assistance + Demonstrate expertise in payer landscapes and insurance processes. Remain knowledgeable about long and short-range changes in the reimbursement environment including Medicare,… more