• Specialist, Appeals Claims…

    Lincoln Financial (Richmond, VA)
    …reviews for multiple product lines. You will perform and deliver on appeals claims assignments/projects while simultaneously leveraging and applying knowledge. ... You will analyze and manage a caseload of appeals claims . You will review, investigate, and...+ Effectively utilize and implement policies & procedures regarding medical terminology, duration, functionality documentation, and overall claims… more
    Lincoln Financial (08/01/25)
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  • IRE Grievance & Appeals Mgr II

    Elevance Health (Norfolk, VA)
    **Manager II Grievance/ Appeals ** **- Claims Support** **Office Locations:** _The selected candidate must reside within a reasonable commuting distance of the ... an accommodation is granted as required by law._ The **Manager II Grievance/ Appeals ** responsible for management oversight of grievances and appeals departmental… more
    Elevance Health (07/15/25)
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  • Medicare Grievances and Appeals Corporate…

    Humana (Richmond, VA)
    …Corporate Medical Director relies on medical background and reviews health claims and preservice appeals . The Corporate Medical Director works on ... + Medical utilization management experience, + working with health insurance organizations, hospitals and other healthcare providers, patient interaction, etc. +… more
    Humana (06/18/25)
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  • Spec, Quality Assurance I

    TEKsystems (Reston, VA)
    …ESSENTIAL FUNCTIONS: 50 Independently researches contractual benefits limitations exclusions and claims to assist medical professional staff in performing the ... 5 years experience in settings such as managed care health care or insurance payor environment 2 years experience in Appeals Management Preferred Qualifications… more
    TEKsystems (07/25/25)
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  • Medical Billing Specialist

    Robert Half Accountemps (Richmond, VA)
    …in the United States. Benefits are available to contract/temporary professionals, including medical , vision, dental, and life and disability insurance . Hired ... Description We are looking for a highly skilled Medical Billing Specialist to join our team on...contribute to healthcare operations by ensuring accurate billing, resolving claims , and supporting patient scheduling. Based in Richmond, Virginia,… more
    Robert Half Accountemps (07/30/25)
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  • CBO Insurance Resolution Specialist

    University of Virginia (Charlottesville, VA)
    …Office has assigned AR responsibility. + Performs inpatient/outpatient follow up and working insurance denials, appeals claims as defined by payer and ... insurance companies. They are responsible of ensuring all claims billed are in compliance with all federal and...and payer websites as well as the knowledge of medical billing and coding guidelines to resolve insurance… more
    University of Virginia (05/15/25)
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  • Medical Director - Florida

    Humana (Richmond, VA)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance , other healthcare providers, clinical group practice management. +… more
    Humana (07/29/25)
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  • Medical Director - South Carolina SE Region

    Humana (Richmond, VA)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance , other healthcare providers, clinical group practice management. +… more
    Humana (07/22/25)
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  • Representative II, Accounts Receivable

    Cardinal Health (Richmond, VA)
    …billing queue as assigned in the appropriate system. + Manages and resolves complex insurance claims , including appeals and denials, to ensure timely and ... **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work...benefits and programs to support health and well-being. + Medical , dental and vision coverage + Paid time off… more
    Cardinal Health (07/24/25)
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  • Medical Director - NorthEast Region

    Humana (Richmond, VA)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance , other healthcare providers, clinical group practice management. +… more
    Humana (07/25/25)
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