Denial Appeals Coordinator - United States

This customer service representative role involves providing expertise and general support to teams in reviewing appeals and grievances, communicating with internal parties regarding issues, implications, and decisions. · ...

Description · Job Summary · The Appeal Specialist II reviews, analyzes, and resolves insurance denials to ensure accurate reimbursement and regulatory compliance. This role logs and reviews denials for trend reporting, provides feedback to facilities, and communicates payer updat ...

· Description · Resolves grievances, appeals and external reviews for one Health Plan LOBs. Ensures regulatory compliance, timeliness requirements set by regulatory agencies, and accuracy standards are met. Coordinates efficient functioning of day-to-day operations according to ...

+The Supervisor, Clinical Appeals oversees the coordination of audit and medical necessity denial appeals for their assigned team. · + · +Associate Degree in Nursing, Healthcare Administration, or a related field preferred · 3-5 years of experience in healthcare appeals, denials ...

JOB DESCRIPTION Job Summary · Provides senior level support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution to members or authorized representatives in accordance with the standards and requirements established ...

Description · Job Summary · The DRG Denials Auditor conducts hospital inpatient DRG denial audits for both RAC and non-RAC accounts, reviewing patient records for accuracy in ICD-10-CM/PCS coding, DRG assignments, and supporting clinical documentation. This includes evaluating pr ...

The position provides support for claims activities including reviewing and resolving member and provider complaints in accordance with the standards established by the Centers for Medicare and Medicaid Services. · ...

About IntusCare · IntusCare is the only end-to-end ecosystem built specifically to help Programs of All-Inclusive Care for the Elderly (PACE) programs deliver exceptional care, strengthen financial performance, and stay compliant. IntusCare replaces outdated technology and manual ...

The Senior Medicare Biller is responsible for overseeing and managing Medicare billing processes for ambulance transports in compliance with federal state and payer-specific regulations. · ...

:Position Objective: · To write clear and persuasive fundraising and advocacy copy for PETA entities worldwide to drive donor response · Primary Responsibilities and Duties: · Write and revise direct mail and email appeals, SMS appeals, landing pages, acknowledgment letters, and ...

Denials and Appeals Analyst · Singing River Health System Administrative Building - Gautier | Full-Time | Monday-Friday 8:00am-4:30pm | · 2101 US-90 · Gautier, Mississippi · United States · Position Overview · The Denials and Appeals Analyst assists in the recovery of Health Sy ...

Description · Inova Health is looking for a dedicated Reimbursement Manager to join the team, this role will be full-time day shift Monday-Friday, 8:00 a.m.- 5:00 p.m., Remote · The Reimbursement Manager develops, prepares, and presents the financial impact of all new and propose ...

Paramele Disability Advocates seeks a mission-driven Veterans Affairs (VA) Attorney to represent veterans in their claims for disability compensation before the U.S. Department of Veterans Affairs (VA) and the Board of Veterans' Appeals. · ...

Benefits: · 401(k) · 401(k) matching · Competitive salary · Dental insurance · Health insurance · Opportunity for advancement · Paid time off · Billing Manager · Behavioral Health (Virginia Medicaid – DMAS / ARTS) · Location: Remote Virginia-Based · Employment Type: Full-Time · S ...

The Utilization Management Manager is responsible for the overall management of the UM department by leading and facilitating review of assigned admissions, · continued stays, utilization practices and discharge planning according to approved clinically valid criteria. · Assigns ...

Las Vegas Petroleum is seeking a talented Video Editor to join our media and marketing team. This position will play a pivotal role in creating compelling video content that showcases our travel centers, promotes our services, and enhances brand engagement. · ...

Screen reader users may encounter difficulty with this site. For assistance with applying, please contact hr- If you have questions while submitting an application, please review these frequently asked questions. · Current Employees and Students: · If you are currently employed o ...

Wellfleet, a Berkshire Hathaway company, delivers customer-centric accident and health insurance, with quality service and uncompromising ethics. Wellfleet works to protect people against risk throughout every stage of life – from grade school to college to the workplace. · Foun ...

We are seeking a dynamic and dedicated Volunteer Donor Relations Manager to builds and maintains strong connections with supporters (individuals, corps, foundations) to increase fundraising, · retention, and engagement through stewardship, · personalized cultivation grant writing ...

Join a mission-driven team dedicated to delivering high-quality patient care as Utilization Review Coordinator. · Support Case Management and Utilization Management operations by ensuring patients receive right care at right time. · ...