Medical Claim Appeals Specialist - United States

Researches and responds to inquiries from providers, suppliers, beneficiaries, health plans, or others involved in the appeals/dispute process. May conduct phone calls with appellants for the purpose of scheduling phone discussions with the company decision maker. · ...

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. · ...

+ Academic Appeals Specialist + · American Public University System +The Academic Appeals Specialist is responsible for responding to student appeal requests, investigating and delivering appropriate appeal outcomes,+Responsibilities:Serves as a point of contact for first-level e ...

Analyze, triage, investigate, research and process standard and escalated appeals , complaints or state complaints from members , providers , health plans and state agencies . · Able to work overtime as needed. · ...

This position reviews provider billing/claims appeals and reconsiderations, supports legal responses to medical billing disputes, and ensures compliance with Workers' Compensation regulations and best practices. · ...

Paradigm is seeking a full-time, remote Provider Appeals and Legal Liaison to lead the interface between the Medical Bill Review/Claims team and Paradigm's Legal department. · Workers' Compensation Medical Bill Review and Provider Appeals · ...

The Appeals Support Representative role directly supports the Clinical Appeals Specialist in the administrative functions of Denials and Appeals within the Utilization Review Team.Essential Job Functions: · Complete outbound calls to payers for status updates on retro authorizat ...

The Denials & Appeals Coordinator is responsible for managing, tracking, and resolving denials and appeals to ensure timely reimbursement. · ...

The DRG Denials Auditor conducts hospital inpatient DRG denial audits. · Reviews patient records for accuracy in ICD-10-CM/PCS coding, DRG assignments, and supporting clinical documentation. · Evaluates present on admission (POA) indicators, discharge disposition, and any other r ...

The Manager is responsible for the day-to-day Appeals and Denials process by providing general oversight including leadership for the inpatient DRG/Coding Denials and Appeals process which includes tracking prioritizing trending and writing appeal letters identifying training and ...

OneOncology is positioning community oncologists to drive the future of cancer care through a patient-centric model. · Confirm insurance benefits for patients · ...

We are seeking an Accounts Receivable Specialist to join our team in the Central Billing Office. The successful candidate will be responsible for supporting the efficient and effective financial operations of the hospital. · Support the Central Billing Office by working closely w ...

The medical billing specialist will be responsible for all activities related to health insurance and medical billing. · ...

We are looking for a Denial Management Specialist to join our revenue cycle team. · This position is responsible for reviewing, analyzing and resolving denied insurance claims to ensure accurate and timely reimbursement for services.Work denied claims from insurance carriers iden ...

The Payer Specialist is responsible for performing duties of utilization review assisting case managers with patient accounts patient type timely payer authorizations for initial and continued stay. · Effective communication with payers case managers patient access financial serv ...

The Payer Specialist is responsible for preforming duties of utilization review assisting case managers with patient accounts and timely payer authorizations. · Effective communication with payers, case managers, patient access, financial services and clinical disciplines to capt ...

SetPoint Medical's Market Access Specialist will facilitate patient access to support the launch of the first neuroimmune modulation therapy to treat rheumatoid arthritis in the US. · ...

Collect monies owed by insurance carriers and privately paying patients. Ensure accurate and timely billing processes, maximizing revenue and supporting financial operations. · ...

We are seeking an insurance collections specialist responsible for collecting monies owed to the accounts receivable by insurance carriers or privately paying patients for the practice. · Review Accounts Receivable aging and contact insurance companies to determine the status of ...

The Revenue Cycle Denial and Underpayment Analyst contributes to the collection of revenue through denial and underpayment appeals. · ...