- Daiichi Sankyo, Inc. (Seattle, WA)
- …purpose of this role is to serve as a field-based, product access specialist that provides appropriate reimbursement support to HCPs to help facilitate patient ... of care on payer specific nuances related to utilization managements protocols and appeals Partner with DSI oncology field staff to ensure aligned customer approach.… more
- TEKsystems (Austin, TX)
- Description: Job Summary: The Revenue Cycle Denials and Appeals Specialist will be responsible for building and maintaining collaborative and productive ... the designated revenue cycle function, with a focus on Denials and Appeals * Performs analysis, identifies trends, presents opportunity areas, and prioritizes… more
- CDPHP (Albany, NY)
- …values and invites you to be a part of that experience. The Clinical Appeals Specialist is responsible for adhering to a member/provider appeal and grievance ... Using knowledge of clinical nursing and medical practices, the Clinical Appeals Specialist will review medical necessity requests, render determinations… more
- UCLA Health (Los Angeles, CA)
- …commitment to accuracy and quality in claim processing. As an Audit and Appeals Specialist , you will: + Facilitate responses to regulatory audits related ... in various systems + Review claim denials for clinical issues, prepare appeals , and manage each case's resolution process + Develop internal compliance controls,… more
- St. Luke's University Health Network (Allentown, PA)
- …regardless of a patient's ability to pay for health care. The Coding Appeals Specialist retrospectively reviews patient medical records, claims data and coding ... or AMA CPT, are assigned to support the services/treatment rendered. The Coding Appeals Specialist also prepares appeal arguments and/or letters to support and… more
- TEKsystems (Jackson, MS)
- Revenue Cycle/ Appeals Specialist Needed Description: 100% Remote Equipment Provided The Appeals Specialist 1, under the direction of the Director of ... processes. Skills: medical claims processing, insurance claim, insurance collections, appeals , revenue cycle Additional Skills & Qualifications: -2 years of… more
- University of Utah (Salt Lake City, UT)
- …Number** PRN40045B **Job Title** Outpatient/Provider Coder Level 3 **Working Title** Medical Appeals Coding Specialist SR **Job Grade** E **FLSA Code** Nonexempt ... Coder-Hospital ( CPC -H), Certified Professional Coder-Payer ( CPC -P), Certified Coding Specialist ( CCS ), Certified Coding Specialist - Physician Based (… more
- TEKsystems (Addison, TX)
- …to strengthen appeal arguments. Additional Skills & Qualifications: - Proven experience as an Appeals and or denials Specialist or in a similar role within a ... reimbursement issues to identify the root causes. - Initiate and manage the appeals and arbitration process for denied or underpaid claims, ensuring timely and… more
- Generac Power Systems (Waukesha, WI)
- …technology solutions company, we continue to push new boundaries. **Job Summary:** The ** Appeals and Grievances Specialist ** is a critical team player who is ... under general supervision with some guidance from leadership and higher-level Appeals and Grievances Specialists. **Job Responsibilities:** Case Resolution + Handles… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, ... achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will...Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve member and… more
