Clinical Appeals Reviewer - Tampa

· Company Description · HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest a ...

Overview: Our client, a US Fortune 50 organization and a leading provider of Healthcare and Health Insurance services, seeks an accomplished Medical Claims/ Appeals Specialist · Position: Medical Claims/ Appeals Specialist · Location: Tampa, FL · Duration: 6-12 months+ temp-to-hi ...

+Responsible for prompt and accurate submission and follow-up of all third party claims. · +Contact payers regarding outstanding claim status and determine appropriate action for swift resolution of outstanding claims. · Process appeals and claim resubmissions per payer policy an ...

Provides entry level support for claims activities including reviewing and resolving member and provider complaints. · ...

The Reimbursement Recovery Specialist is responsible for securing the payment of medical claims in a timely and efficient manner. · Takes steps to secure payment on aged receivables by making outbound calls, utilizing payer portals. · Analyze denied or partially paid claims and d ...

Facility Location · NATIONAL EEO SVC FACILITY · 5405 CYPRESS CENTER DR STE 330 · TAMPA, FL · This is NOT a remote position. · Position Information · NON-SCHEDULED DAYS: SAT/SUN · HOURS: 08:00 AM to 05:00 PM EST · BENEFIT INFORMATION: The salary will be based on previous experien ...

Associate Attorney – Federal Social Security Disability Appeals · The Federal Appeals Firm (Konoski & Partners, P.C.) · Remote to start (with likely transition to in-office) · Attorney Should be Based in or near Tampa, Florida · About the Firm · The Federal Appeals Firm is a nat ...

The Appeals Examiner plays a critical role within the team by managing and processing provider reconsiderations and appeals with utmost accuracy and compliance. · The examiner collaborates with cross-functional teams to deliver timely resolutions and supports ongoing improvements ...

Summary · The Caregiver Support Program (CSP) is one of the Veterans Health Administration's (VHA) most rapidly growing service areas. CSP expansion puts the VHA into the role of healthcare system pioneer-caring directly for the caregiver. The Physician (Caregiver Support Program ...

Responsible for prompt and accurate submission and follow-up of all third party claims. · Reviews assigned accounts perform status inquiry and appeals to 3rd party payers to ensure reimbursement. · ...

Responsible for prompt and accurate submission and follow-up of all third party claims. Reviews assigned accounts perform status inquiry and appeals to 3rd party payers to ensure reimbursement. Reviews assigned accounts, determines appropriate action to resolve outstanding balanc ...

This role enables associates to work virtually full-time except for required in-person training sessions providing maximum flexibility and autonomy. · Conducts investigations and reviews of member and provider appeals · Reviews prospective inpatient or retrospective medical reco ...

The Nurse Appeals Senior is responsible for investigating and processing the most complex appeals requests from members and providers. ...

Responsible for prompt and accurate submission and follow-up of all third party claims. Reviews assigned accounts perform status inquiry and appeals to 3rd party payers to ensure reimbursement. Reviews assigned accounts, determines appropriate action to resolve outstanding balanc ...

This position is incentive eligible. Do you want to join an organization that invests in you as a Manager Appeals? At Parallon, you come first. · ...

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partne ...

The Appeals Manager is responsible for managing all activities related to monitoring and appealing denials received from Third Party Payers. · In this role you will:Manage daily activities and inventory related to SSC Appeals function, · ensuring processes are performed accuratel ...

Facility Location · NATIONAL EEO SVC FACILITY · 5405 CYPRESS CENTER DR STE 330 · TAMPA, FL · This is NOT a remote position. · Position Information · NON-SCHEDULED DAYS: SAT/SUN · HOURS: 08:00 AM to 05:00 PM EST · BENEFIT INFORMATION: The salary will be based on previous experien ...

A Medical Coder reviews adjudicated medical claims that have been denied for reconsideration following company-specific reimbursement policies. · Reviews coding accuracy and medical records details to determine if denial reasons are valid or payment reconsideration warranted. · A ...

Provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. · ...