Appeals and Denials Specialist

Job Type Full-time Description The Appeals and Denials Specialist is responsible for triaging and writing DRG downgrades and clinical validation appeal letters for multiple clients. The Appeals and Denials Specialist will ensure appropriate action is taken within appeal deadlines. This position collaborates with the Appeals and...

Responsible for all activities associated with appeal analysis, decision-making and closure as described below:Appeal Intake Validate intake determinations regarding timeliness, member benefits, employer group, and provider contract provisions for Appeals Specialist, Appeals, Specialist, Processing, Healthcare, Medical, Information

Job Description Job Description Overview: Demonstrate competency as a claims resolution specialist for a large-scale multi-specialty/multi-site healthcare organizations in the U.S. Perform claims resolution or medical billing and appeals or claims denials in Athena within the last two years. Conduct AR Follow-up both on front end scrubs and back end denials...

Job DescriptionJob DescriptionOverview: Demonstrate competency as a claims resolution specialist for a large-scale multi-specialty/multi-site healthcare organizations in the U.S.Perform claims resolution or medical billing and appeals or claims denials in Athena within the last two years.Conduct AR Follow-up both on front end scrubs and back end denials...

Medicaid Application Specialist BaneCare Management is currently seeking Full Time Medicaid Application Specialist to join our team! Our Medicaid Application Specialist role would be based out of our corporate office, conveniently located in Braintree, MA. If youre passionate about the healthcare industry and are interested in joining a growing organization...

Job DescriptionJob DescriptionDescriptionGood Shepherd Hospice, a leading regional provider of hospice care, is seeking a full-time, experienced Hospice Medicare Billing Specialist for our corporate office in Oklahoma City.Full-time position / Monday through Friday, 8am to 5pm Medicare Hospice Biller strongly preferredKey ResponsibilitiesFile...

Job DescriptionJob DescriptionDescriptionGood Shepherd Hospice, a leading regional provider of hospice care, is seeking a full-time, experienced Hospice Medicare Billing Specialist for our corporate office in Oklahoma City.Full-time position / Monday through Friday, 8am to 5pm Medicare Hospice Biller strongly preferredKey ResponsibilitiesFile...

Job DescriptionJob DescriptionJob Title: Accounts Receivable RepresentativeFSLA Status: Full Time, Non – ExemptReports to:Salary: $14.00 - $18 per hour* Starting pay varies based on location and experience, in compliance with specific state wage regulations. Competitive rates tailored to your geography and expertise.Summary/ObjectiveProvide a quality...

Job DescriptionJob DescriptionInsurance A/R Specialist for our FL Regional Office in Panama City, FLNHC HomeCare Florida Regional Office is looking for an Insurance A/R Specialist to join our team. This position works under the direction of the Billing Manager to assure the accurate and timely collection of Homecare accounts receivable from Medicare, managed...

Job DescriptionJob DescriptionWe are searching for a diligent Medi-Cal Claim Follow-Up Specialist to ensure the timely and accurate collection of medical claims. The specialist will work closely with counties to rectify payment denials and receive due reimbursements. The ideal candidate will possess strong communication skills, a deep understanding of...

Job DescriptionJob DescriptionWe are searching for a diligent Medi-Cal Claim Follow-Up Specialist to ensure the timely and accurate collection of medical claims. The specialist will work closely with counties to rectify payment denials and receive due reimbursements. The ideal candidate will possess strong communication skills, a deep understanding of...

Utilization Specialist Job Responsibilities:Act as liaison between managed care organizations and the facility professional clinical staff.Conduct reviews, in accordance with certification requirements, of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements.Monitor patient...

Job DescriptionJob DescriptionMedical Billing Auditor | Medical Insurance Denial RepresentativeOKC, OK M-F 8a-5p$17-$20/HRExperience reading EOBsWork denials and understand denial codes and modifiers2+ years current experience requiredThe Billing Office Representative is responsible for processing medical claims. Duties include for verifying all patient...

Job DescriptionJob DescriptionMedical Billing Auditor | Medical Insurance Denial RepresentativeOKC, OK M-F 8a-5p$17-$20/HRExperience reading EOBsWork denials and understand denial codes and modifiers2+ years current experience requiredThe Billing Office Representative is responsible for processing medical claims. Duties include for verifying all patient...

Job DescriptionJob DescriptionDescription:The Collections Specialist is a vital member of the Compass Revenue Solutions. The Collections Specialist is under the supervision on the Director of Finance. The Collections Specialist is responsible for collections of outstanding accounts receivable dollars from the insurance payersRequirements:Essential Duties: ...

Job Description​Saint Luke's Health System in Kansas City is seeking a Patient Accounts Specialist to join our team. You will perform a variety of functions related to managing the accounts receivable, following established processes and polices for billing and reimbursement. Shift Details: Full Time Day Responsibilities: Patient Account Specialist...

Summary This position serves as a Human Resources Specialist located in the Employee Management Relations Branch, Human Resources (HR) of the Joint Administrative Operations (JAO), . Fish and Wildlife Service (FWS). Serves as an Employee Relations (ER) Specialist on ER programs including policy guidance and advice to senior leadership, program...

More Information about this Job: CLINICAL EDUCATION SPECIALIST *This position supports Eastern Kansas Operations, hybrid work locations $(phone number removed) / year    We’re hiring a Clinical Education Specialist responsible for the creation, implementation, and tracking of the Clinical and Education services and...

Job Description​ Saint Luke’s Health System in Kansas City is seeking a Patient Accounts Specialist to join our team. You will perform a variety of functions related to managing the accounts receivable, following established processes and polices for billing and reimbursement.     Shift Details:  Full Time Day   Responsibilities:   Patient...

Are you a Nursing Home Medicaid EXPERT? Bear Mountain Healthcare is currently seeking a full time Medicaid Pending Specialist to assist in the completion of Medicaid applications, conversions, and reviews in various facilities in Massachusetts. Duties include: · Responsible for working Pending Medicaid applications and re-determinations in order to ensure...