- 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
- 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
- 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
- Trinity Health (Farmington Hills, MI)
- …as part of the payment resolution team that receives, analyzes, and appeals denials received for an assigned PBS location. Reviews, researches and resolves ... knowledge of state/federal laws as they relate to contracts and the appeals process. Investigates and addresses overpayment and underpayment accounts with the… more
- Molina Healthcare (TX)
- …Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare Management + Certified Professional in Healthcare Quality + other ... discussed during our interview process._** **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and correct clinical decisions… 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
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Coding Charges & Denials Specialist is responsible for coordinating and monitoring the coding-specific clinical charges and denial ... management and appeals process in a collaborative environment with revenue cycle...metrics are reported appropriately including specific current procedural terminology (CPT)/ healthcare common procedure coding system (HCPCS), denial reasons, and… 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
- Robert Half Accountemps (Cincinnati, OH)
- Description We are offering a unique opportunity in the healthcare industry for a Denials Specialist located in Cincinnati, Ohio. This role involves reviewing ... and managing billing processes for a healthcare facility, with a focus on claim... facility, with a focus on claim denials and appeals . The employment type for this role is temporary.… more
- City and County of San Francisco (San Francisco, CA)
- The Department of Public Health prioritizes equitable and inclusive access to quality healthcare for its community and values the importance of diversity in its ... in class 1231 Equal Employment Opportunity (EEO) Programs Senior Specialist . The eligible list resulting from this recruitment may...Rule 111A.35.1. The standard for the review of such appeals is 'abuse of discretion' or 'no rational basis'… 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
- Elevance Health (Woodland Hills, CA)
- **Plan to Plan Service Specialist I** **Location :** Ideal candidates will live within 50 miles of an Elevance Health PulsePoint office location. The Plan to Plan ... Service Specialist I is responsible for serving as a single...business partners (Provider Relations, customer service, account management, claims, appeals , etc.) and external contacts within the other plans… more
- Spectrum Billing Solutions (Skokie, IL)
- Spectrum Billing Solutions is a revenue cycle management company for healthcare organizations. We are looking to add a passionate and skilled Revenue Cycle AR ... Collections Specialist to our growing team. The ideal candidate will...all aspects of revenue cycle collections including denial management, appeals , reimbursement rate negotiation, and accounts receivable collections. This… more