Hybrid Ebilling Appeals Specialist - New York - Davis Polk

We are a leading authority in payment integrity solutions including DRG Validation, Cost Outlier and Readmission reviews.The Appeals Specialist level II performs research, investigation, · and analysis of appeals, · grievances, ...

Respond to written/verbal grievances and complaints submitted by members and providers in accordance with NCQA, CMS, State and other regulations. · ...

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. · Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility ...

Summary Of Job · Respond to written/verbal grievances, complaints, appeals and disputes submitted by members and providers in accordance with NCQA, CMS, State and other regulations. Process appeals and grievances to facilitate the accurate administration of benefits and clinical ...

Summary of Job · Respond to written/verbal grievances, complaints, appeals and disputes submitted by members and providers in accordance with NCQA, CMS, State and other regulations. Process appeals and grievances to facilitate the accurate administration of benefits and clinical ...

The Appeals & Grievances (A&G) unit manages Healthfirst member complaints, grievances and appeals that are presented by the member or provider pertaining to the authorization of or delivery of clinical and non-clinical services. · Responsible for case development and resolution o ...

The Appeals & Grievances (A&G) unit manages Healthfirst member complaints, grievances and appeals that are presented by the member or provider pertaining to the authorization of or delivery of clinical and non-clinical services. · ...

The Appeals & Grievances (A&G) unit manages Healthfirst member complaints, grievances and appeals that are presented by the member or provider pertaining to the authorization of or delivery of clinical and non-clinical services. · A&G works in collaboration with divisions within ...

Focused on employment and labor law since 1958, Jackson Lewis P.C.'s 1,000+ attorneys located in major cities nationwide consistently identify and respond to new ways workplace law intersects business. We help employers develop proactive strategies, strong policies and business-o ...

Law firm seeks an experienced E-Billing Specialist to join growing Accounting team. · The specialist will retrieve invoice backups from e-billing platforms, review deductions and appeal strategies. · ...

Legal E-Billing Specialist · Job Summary · We are a mass tort litigation firm seeking a skilled and detail oriented Legal E-Billing Specialist / Billing Analyst to join our team. This role would assist in the assembly and issuance of monthly legal bills through the assigned e-bi ...

We combine psychotropic medications with evidence-based dietary supplements,nutraceuticals,and lifestyle adjustments to enhance overall well-being.Collaboration with other medical professionals is a cornerstone of our practice to ensure comprehensive care for patients. · Investig ...

This is a full-time remote role for a Digital Marketing Specialist. The Digital Marketing Specialist will be responsible for developing and executing online marketing strategies and campaigns to enhance brand visibility and engagement. · Managing social media platforms · Analyzin ...

The Workers Compensation Specialist plays a crucial role in ensuring that patients receive comprehensive and coordinated care throughout their healthcare journey. · ...

Description · 3034464: Utilization Insurance Specialist -Psychiatry Child Inpatient Unit -MSM- Full Time Day · Job Summary:  · To provide clinical information to Managed Care/Insurance Companies/BHO to demonstrate medical necessity and ensure reimbursement. · Responsibilities · R ...

We are looking for an Executive Administrative Assistant to directly support our C-Level Executives and operations. · ...

The Clinical Review Specialist (RN) conducts clinical reviews of inpatient medical appeals for medical necessity and quality of care. · Review appeal cases for medical necessity. · Analyze medical records. · Prepare summaries and rationale. · ...

The Senior Billing Specialist will be responsible for end-to-end billing and reimbursement for personal exoskeletons and physical therapy practices. · This includes benefits verification, claims submission, denial management, · appeals, payer enrollment and follow-up.4 weeks PTO ...

+ Provide clinical information to Managed Care/Insurance Companies/BHO for reimbursement; responsible for concurrent review program, insurance certification, authorization process in Psychiatric or Chemical Dependency Inpatient Units + Develops rapport with admitting clinicians f ...

This is a part-time, remote role as an Insurance Claims Resolution Specialist based in New York. The main responsibility of this role will be to resolve unpaid and underpaid insurance claims. · Investigate unpaid and underpaid insurance claims · Call, message, and follow up with ...

Wandercraft provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to color, religion, sex, sexual orientation, gender identity, national origin, age or disability. · At Wandercraft we pioneer intelligent robotics to help peopl ...