- Jazz Pharmaceuticals (New York, NY)
- …and ensure providers understand payer prior authorization requirements, appeals process, clinical criteria, and appropriate coding information.Demonstrate deep ... surrounding Commercial Payers, state Medicaid Agencies, Managed Medicaid Organizations, Healthcare Maintenance Organizations, Pharmacy Benefit Organizations, Health Care Plans,… more
- HCA Healthcare (Nashville, TN)
- …you want to join an organization that invests in you as an Appeals Specialist ? At Parallon, you come first. HCA Healthcare has committed up to $300 million ... + Employee Stock Purchase Plan with 10% off HCA Healthcare stock + Family support through fertility and family...make a difference. We are looking for a dedicated Appeals Specialist like you to be a… more
- Trinity Health (Farmington Hills, MI)
- …familiarity with third party billing requirements and regulations, and writing appeals . Certification within Healthcare Financial Management Association (HFMA) ... Position (Pay Range: $39.8218-$59.7327) Applies clinical and comprehensive payer and appeals knowledge in reviewing all post-billed denials (inclusive of clinical… more
- Universal Health Services (Richmond, VA)
- …The Atlantic Region CBO is seeking a dynamic and talented Senior Appeals Specialist . The Senior Appeals Specialist ... and oral communication skills are required + Familiarity with appeals and 3-5 years healthcare business office...+ Familiarity with appeals and 3-5 years healthcare business office experience preferred Disclaimer The Atlantic Region… more
- Universal Health Services (Richmond, VA)
- …Rico and the United Kingdom. The Atlantic Region CBO is seeking a dynamic and talented Appeals Specialist . The Appeals Specialist is responsible for the ... and oral communication skills are required + Familiarity with appeals and 1-3 years healthcare business office...+ Familiarity with appeals and 1-3 years healthcare business office experience preferred This opportunity provides the… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Quality Auditing Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: ... achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Quality Auditing (QA) Specialist ...Required: At least 4 years of experience in auditing Appeals & Grievances in a healthcare environment… more
- Trinity Health (Farmington Hills, MI)
- …Responsible for leveraging clinical knowledge and standard procedures to track appeals through first, second, and subsequent levels, and ensuring timely filing ... of appeals as required by payers, in addition to promoting...and reviews findings with all levels of Payment Resolution Specialist for further review. Serve as a resource to… more
- Abbott (Plano, TX)
- …Our 114,000 colleagues serve people in more than 160 countries. **Sr. Appeals Specialist , Patient Therapy Access Team** **Position Location: 6600 Pinecrest ... Abbott is a global healthcare leader that helps people live more fully...**Plano, TX** currently has an opportunity for a **Sr. Appeals Specialist ** . This role is responsible… more
- MCG Health System (Augusta, GA)
- Denials and Appeals Specialist Work Location: Satellite Location Req Number: 35021 Department Name: Prof Rev Cycle Svcs Shift: Days/No Weekends Position Status: ... returnto the Search Results or Job Cart. Position Description The Denials and Appeals Specialist is responsible for timely and accurate resolution of denied… more
- Universal Health Services (Bonham, TX)
- …day. TMC Bonham is managed by Texoma Medical Center, subsidiary of UHS. The Appeals Specialist is responsible for appealing all insurance denials and prepare ... payers in compliance with Managed Care contracts and government fee schedules. The Appeals Specialist will obtain, manipulate, and analyze data from a variety… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Training Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los ... net required to achieve that purpose. Job Summary The Customer Solutions Center Appeals and Grievances (A&G) Training Specialist II is primarily responsible for… more
- ManpowerGroup (Columbia, SC)
- Job Tittle: Appeals Specialist Location: Columbia, SC Duration: 6+ Months Pay Rate: $17/hr We are looking for an Appeals Specialist (Data entry) to join ... one of our Fortune 500 Healthcare clients. **Job Description** + Performs non-medical reviews and processes redetermination letters. + 50% Performs non-medical… more
- Alameda Health System (San Leandro, CA)
- Care Management Clinical Appeals Specialist + San Leandro, CA + Finance + Patient Financial Svcs - Facil + Full Time - Day + Business Professional & IT + Req ... Coordinates and executes the appeal process for all AHS facilities clinical appeals and third party audits. **DUTIES & ESSENTIAL JOB FUNCTIONS:** NOTE: The… more
- Hartford HealthCare (Farmington, CT)
- …this is *your moment.* **Job:** **Finance / Patient Accounts* **Organization:** **Hartford HealthCare Corp.* **Title:** *Collections Specialist / PA Third Party ... where every moment matters. Every day, over 38,000 Hartford HealthCare colleagues come to work with one thing in...revenue cycle performance. The AR Follow Up & Denials Specialist is responsible for resolving unpaid third party balances… more
- Sharp HealthCare (San Diego, CA)
- …information necessary for activities related to Medical Groups' Quality and Appeals processes. + Demonstrates knowledge of department policies and procedures ... level of care in IDX per Medical Group guidelines. Collaborates with Medical Group Appeals on members with SNF services under appeals process.Reviews SNF claims… more
- Hackensack Meridian Health (Hackensack, NJ)
- …our community. Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change. The **Appeal Nurse ... Specialist ** will be responsible for the timely review and submission of appeals for denied managed care inpatient and/or outpatient claims to insurance companies… more
- HCA Healthcare (Asheville, NC)
- …diversity and inclusion thrive? Submit your application for our Insurance and Claims Specialist (Program of All Inclusive Care for the Elderly) Program opening with ... truly means to be a part of the HCA Healthcare team. **Benefits** CarePartners, offers a total rewards package...vary by location._** We are seeking Insurance and Claims Specialist PACE Program, for our team to ensure that… more
- Hartford HealthCare (Hartford, CT)
- …this is your *moment*. **Job:** **Administrative* **Organization:** **Hartford HealthCare Medical Group Specialists* **Title:** *Prior Authorizations Specialist ... where *every moment* matters. Every day, almost 30,000 Hartford HealthCare employees come to work with one thing in...Under the direction of the Manager, a Prior Authorization Specialist performs all clerical duties required to obtain insurance… more
- Maxim Healthcare Services (Columbia, MD)
- The Reimbursement Specialist I reviews branch sales for appropriate documentation, generate and bill claims and/or invoices, follows up on unpaid accounts, and ... unpaid accounts after expected payment timeframe + Corrects, resubmits claims and/or appeals claim determinations as necessary to ensure payment + Follows all… more
- TEKsystems (Tampa, FL)
- …if there are any additional actions needed including copay, prior authorization, appeals , appointments, etc., as well as communicating directly with health insurance ... Shift: 8:30am-5:00pm EST MUST HAVES: + 2+ years of HEALTHCARE experience within a healthcare facility or back office (benefits knowledge, familiarity with payers… more
