Clinical Appeals Reviewer - Dallas, TX

This position is National Remote. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. · At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality ...

This position allows you to telecommute from anywhere in the U.S., working on challenging tasks. · You'll enjoy flexibility while taking on some tough challenges. · At UnitedHealthcare,we're simplifying the health care experience,creating healthier communities,and removing barrie ...

The USPI Utilization Review/Appeals RN facilitates effective resource coordination for patients. · Manages medical necessity process for accurate payment · Covers utilization management services and denial prevention · ...

The USPI Utilization Review/Appeals RN facilitates effective resource coordination to help patients achieve optimal health access to care appropriate utilization of resources balanced with the patient s resources and right to self-determination across United Surgical Partners Int ...

The USPI Utilization Review/Appeals RN is responsible to facilitate effective resource coordination to help patients achieve optimal health, access to care and appropriate utilization of resources. · ...

RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan. · ...

Associate Medical Director (Family Medicine) · This leadership-focused managed care position will oversee utilization, disease and quality management programs while providing peer-to-peer reviews. · Review prior authorizations & appeals · Conduct peer-to-peer reviews · ...

Associate Medical Director (Family Medicine) · This leadership-focused managed care position involves providing hands-on clinical leadership supporting utilization management, medical policy development, pharmacy coordination, fraud/waste oversight, and managed care quality initi ...

The Denial Resource Center Appeal Support Specialist is responsible for ensuring that complete and accurate appeals of denied claims are submitted to the payer in a timely manner according to guidelines set forth by the payer. · H.S. Diploma/GED Equivalent · EXPERIENCE - 2 Years ...

Job Title: Obstetrics & Gynecology Physician · Responsibilities: · Clinical utilization management oversight including authorizations, appeals, peer reviews pharmacy FWA clinical policy development provider performance evaluation · Work Schedule Monday Friday 8am-5pm No call requ ...

Associate Medical Director Family Medicine · This opportunity supports clinical operations, utilization management, and quality initiatives while making a meaningful impact on patient outcomes across a health plan population. · Review prior authorization & appeals requestsConduct ...

This is a work from home (WFH) opportunity reviewing Explanation of Benefits (EOB) from payors to determine how the claims were managed. Contacting insurance carriers to check on the status of claims appeals and insurance verification. · ...

The Collector is responsible for resolving outstanding surgical claims resulting in maximum reimbursement. · ...

+Job summary · A/R collector responsible for resolving outstanding surgical claims. · +ResponsibilitiesTimely follow-up and resolution on all outstanding A/R including unpaid/underpaid/denied claims. · Manage daily work queues to prioritize high dollar claim balances. · ...

Locums- A great group in Dallas, TX is looking for an Associate Medical Director who specializes in OBGYN for a Locums assignment into a perm rollover · Board Certified OB/GYN · Start ASAP for 3 months then perm rollover · Monday- Friday 8am-5pm · Duties include: Clinical uti ...

Job Description · As Medical Director of Physician Services at Parkland Community Health Plan (PCHP), you will oversee medical coordination efforts to optimize healthcare utilization and quality management within our network. · Key Responsibilities: · Operations: Review appeals r ...

A leading U.S real estate management company is looking to hire a Senior Manager, Real Estate Tax. · Manage the property tax appeal process for all managed and private properties · Quarterly reporting – savings analysis, open appeals report, other reports as assigned · ...

The successful candidate will review, research, and resolve claim denials and appeals for various insurance companies while identifying payment trends in an effort to maximize collections. ...

Job Quick Facts: Specialty: Family Medicine Associate Medical Director Job Type: Locum-to-Perm Facility Location: Dallas, TX Service Setting: Administrative Reason For Coverage: Supplemental Coverage Period: 13 weeks Coverage Type: Clinical only Shift Schedule: Mon-Fri; 8a-5p Cor ...

This is a work from home (WFH) opportunity. · The successful applicant must live within the Greater DFW area and be available to come to the office for equipment pickup, office meetings, and training. · ...