- Community Health Systems (Sarasota, FL)
- (Full-Time, Remote ) The Appeals Specialist I is responsible for reviewing patient accounts denied for insurance reimbursement or paid incorrectly and ... to resolve discrepancies and improve reimbursement rates. As an Appeals Specialist I at Community Health Systems,...accounts by following HIPAA guidelines + **This is a remote position.** We know it's not just about finding… more
- Community Health Systems (Sarasota, FL)
- (Full-Time, Remote ) The Appeals Specialist II is responsible for follow-up of all appeals submitted. This individual manages denial/appeal correspondence ... imperative for the department to run efficiently. As an Appeals Specialist II at Community Health Systems,...accounts by following HIPAA guidelines + **This is a remote position.** We know it's not just about finding… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II Job Category: Administrative, HR, Business Professionals Department: CSC Appeals & Grievances ... net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …will consider collective experience, training and education. . 5 years as an Appeals Specialist or equivalent experience in Medicare health insurance claims, ... and electronic inquiries in order to identify and classify appeals and grievances as outlined in policies and procedures....keyboard, mouse and headset. + Whether you are working remote or in the office, employees have access to… more
- LA Care Health Plan (Los Angeles, CA)
- Appeals & Grievances Regulatory Audit Readiness Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, ... achieve that purpose. Job Summary The Customer Solution Center (CSC) Audit Readiness Specialist II is responsible for the execution, oversight, and monitoring of the… more
- Molina Healthcare (Tampa, FL)
- **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and correct clinical decisions for appeals outcomes within compliance ... standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical/medical reviews of previously denied cases in which a formal appeals… more
- LA Care Health Plan (Los Angeles, CA)
- …and/or exceed member satisfaction. Responsible for the day to day oversight of Appeals and Grievance Specialist by closely monitoring work, providing feedback on ... Lead Customer Solution Center Appeals and Grievances Job Category: Administrative, HR, Business...and or process improvement. Assist Supervisor to ensure that Specialist provide accurate, timely, and quality responses. Ensure that… more
- St. Luke's University Health Network (Allentown, PA)
- …of a patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party denials for medical necessity and tracks ... review. Provides billing with information needed to obtain payment of claims. Remote within local geography after orientation. JOB DUTIES AND RESPONSIBILITIES: +… more
- Weill Cornell Medical College (New York, NY)
- Title: Revenue Cycle Specialist -Revenue Integrity ( Remote ) Location: Midtown Org Unit: AR - Coding Medicine Work Days: Weekly Hours: 35.00 Exemption Status: ... Certifications** + Certified Professional Coder Certificate (CPC) or Certified Coding Specialist (CCS) **Working Conditions/Physical Demands** Remote based work… more
- AdventHealth (Altamonte Springs, FL)
- …we are even better. **Shift** : Full-time; Monday-Friday **Job Location** : Remote **The role you will contribute:** This position is responsible for investigating ... best opportunity for fair reimbursement. The Clinical Denial Management Specialist will adhere to the AHS Compliance Plan and...obtain further patient information to be used in the appeals process if necessary. . Provide reports, education, and… more