Average salary: $72,658 /yearly
More statsSearch Results: 144,549 vacancies
...spent on the particular responsibility - High to Low
1.
Manages workflow for Humana PPI Audits, RAC Audits, or Outpatient Appeals and communicates daily with Sr. Director/Manager on trends identified
2.
Responds to queries within 72hrs, appropriately documents...
Suggested
...Summary of Position
We are seeking a talented Grievance & Appeals Specialist who will be responsible for responding to written/verbal grievances, complaints, appeals, and disputes submitted by members and providers in accordance with NCQA, CMS, State, and other regulations...
Suggested
Work experience placement
...responsible for clinical oversight of assigned grievance and
appeal cases. Utilizes clinical judgement in the assessment, solution... ...)
May serve as a backup to absent Grievance & Appeals Nurse Specialists
Attends meetings as needed including but not limited to Clinical...
Suggested
Permanent employment
Contract work
Immediate start
Remote job
...Appeals and Compliance Specialist
Starting Salary: $84,495 - $101,395
This position reports to the Executive Director and is responsible for managing complaints, informal resolution meetings, mediations, and appeals, ensuring compliance with state and federal laws...
Suggested
Holiday work
Contract work
Work experience placement
Local area
Flexible hours
Overview:
Under the direction of the Supervisor, the Medicare Appeals Specialist receives, investigates, and responds to formal Medicare appeals. The Medicare Appeals Specialist is responsible for evaluating clinical criteria within medical records and associated documentation...
Suggested
Local area
...time off
~ Eight Paid Holidays per year
~ Quarterly incentive plans
*The Akron, OH billing center has multiple openings for Appeals Representatives. These are remote, work-from-home positions*
JOB DESCRIPTION OVERVIEW:
~ The Denials & Appeals...
Suggested
Holiday work
Remote job
Work from home
Join a team of dynamic, results oriented professionals!
Named among "The World's Most Admired Companies" by Fortune Magazine
Named among "America's 100 Most Trustworthy Companies" by Forbes magazine
Named among "Great Places to Work" by Becker's Hospital...
Suggested
Holiday work
Flexible hours
Job TypeFull-timeDescriptionThe 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...
Suggested
Remote job
Flexible hours
...appropriate.
Provide correction suggestions to other departments so the invoice can be resubmitted.
Provide coding direction to appeal invoices and/or submit appeals via payer website or fax, as directed.
Complete reconsideration letters as needed.
Complete...
Suggested
Holiday work
Flexible hours
...Our client is a busy Medical office located in Tarpon Springs. They are seeking a temporary Claims & Appeals Specialist to join their team. The ideal candidate will be able to prioritize tasks, multitask, and have high attention to detail.
Position Responsibilities...
Suggested
Temporary work
Local area
Monday to Friday
...Job Description
Role : Appeals Project Specialist
Estimated Duration : 6+ months
Location: Phoenix, AZ (hybrid)
Position Description
Reviewing medical records and writing administrative reviews- looks at recommendations by doctors, learning Client rules...
Suggested
Remote job
...wide events, professional development (LOMA testing) and a company-wide wellness program.
Scope and Purpose:
The Claims Appeals Specialist is responsible for ensuring professional and compliant processing of all appeals, predetermination requests, consumer...
Suggested
Immediate start
Flexible hours
...Medicare Appeals Specialist
Do you like challenging payers? Enjoy that feeling of satisfaction when your appeal is overturned? Then, this position may is right for you!
The ideal candidate will be well versed in the Medicare managed care appeals and grievance process...
Suggested
Contract work
...Services has a reputation for excellent customer service in the marketplace, and this position is crucial to continuing that status.
Appeals may be submitted by providers and/or their representatives, members, attorneys, and sometimes a PPO (Preferred Provider...
Suggested
Hourly pay
Full time
Temporary work
Monday to Friday
...Summary
SUMMARY: Coordinates and executes the appeal process for all AHS facilities clinical appeals and third party audits.
DUTIES & ESSENTIAL JOB FUNCTIONS: NOTE : The following are the duties performed by employees in this classification. However,...
Suggested
Full time
The Supervisor of Appeals will lead a team of Appeal Specialists and Appeals Coordinators who service clinical and non-clinical appeals, and claim review requests, from all provider types, as well as clinical and non-clinical appeals and claim review requests from members...
...Work Shift:
Day (United States of America)
**The Denials Specialist role is eligible for a $1,500 sign on bonus.**
**This position... ...interpreting denials and facilitating first and second level appeals to insurance.
The ideal candidate will have experience with...
Relocation bonus
Flexible hours
Shift work
Early shift
...beneficial.
Job Description:
~Ability to work with BillBlast platform to generate LEDES files and manipulate invoices for transmission of appeals
~Generate recap reports for attorney review by entering reduction information into Aderant workflow
~Update the status and...
Hourly pay
Temporary work
Remote job
Work from home
Monday to Friday
Overview:
Appeals associate will be responsible for coordinating and monitoring the administrative and non-clinical services for the clinical appeals team. These duties include, but are not limited to, setting up work assignment schedules, investigating, analyzing, providing...
...Responsible for tracking, appealing and resolving denied claims, as well as analyzing reimbursements according to contractual agreements. Performs a variety of duties including accounts receivable follow-up, customer service, correspondence response and daily reconciliation...
Full time
Temporary work
Local area
