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Appeals Specialist Jobs

5,541Jobs

  • 3.8
    Tufts Health Plan – Watertown, MA
    NEW
    Under the general direction of the Appeals and Grievances Supervisor, the Specialist is responsible for ensuring professional… handling of all member and provider appeals and grievances in a timely and efficient way. The Specialist must possess broad understanding…
  • 2.4
    HealthSCOPE Benefits – Little Rock, AR
    17 days ago 17d
    AppealsSpecialist Position Code: 345 Department: Appeals Management Location: Little Rock, Arkansas Immediate Supervisor… Coordinate drafting and mailing of letters related to member appeals Prepare feedback and participate in meetings Obtaining…
  • 3.7
    Children's Hospital (Omaha) – Omaha, NE
    21 days ago 21d
    Center is growing quickly and hiring a Claims Denial & AppealsSpecialist who is responsible for reviewing and analyzing claim denials… appropriate appeals necessary for reimbursement. Receives denied claims and researches appropriate appeal steps Communicates…
  • 3.0
    iRhythm – Lincolnshire, IL
    27 days ago 27d
    Position: AppealsSpecialist Reports to: Senior Manager, Revenue Cycle iRhythm is a leading digital health care company… what they both need answers. Position Summary: The AppealsSpecialist is responsible for managing payer denials by reviewing…
  • 3.6
    Alameda Health System – Oakland, CA
    $46k-$64k(Glassdoor est.)
    NEW
    Health System wants to hear from you! As a Clinical AppealsSpecialist, you will play a key role in optimizing Highland Hospital's… the appeal process, at the direction of the Supervisor and/or physician advisors, until the case is overturned, appeal options…
  • 2.9
    VISITING NURSE SERVICE OF NEW YORK – New York, NY
    $78k-$99k(Glassdoor est.)
    14 days ago 14d
    each grievance or appeal decision. Develops correspondence communicating the outcome of grievances and appeals to enrollees and/… best lives possible. Responsibilities Resolves grievances, appeals and external reviews for one of the following VNSNY CHOICE…
  • 3.3
    Aerotek – Pittston, PA
    Today 3hr
    Responsibilities include: Reviewing case files Researching appeals Analyzing data Making informed decisions regarding next steps…
  • 3.3
    L.A. Care Health Plan – Los Angeles, CA
    10 days ago 10d
    CSC A&G Specialist (A&G Specialist) will receive, investigate and resolve member and provider complaints and appeals exercising… post-service (retroactive review) medical necessity; benefit coverage appeals and reconsiderations, and complex provider claim disputes.…
  • 3.8
    Brigham and Women's Hospital – Boston, MA
    NEW
    HEALTH CORPORATION Job Title: Admitting Department AppealsSpecialist Date: October 13, 2017 Job Code:002234 Grade: 305… Access Services Denial Manager, the Admitting Department AppealsSpecialist is responsible for assisting with insurance denials and…
  • 3.6
    CSI Professional – Norcross, GA
    NEW
    Job Summary The AppealsSpecialist is responsible for performing end to end tasks fortechnical appeals. Duties (included but… not limited to):Triage incoming inventory for the Appeals team, validating appeal criteria ismetCompose technical denial arguments…
  • 3.4
    State of Washington – Olympia, WA
    6 days ago 6d
    . The AppealsSpecialist researches, evaluates, prepares, and presents cases heard by the Presiding Officer. The Appeals Specialist… public programs such as Medicaid. Duties The AppealsSpecialist reports to the Associate Directorfor Legal Servicesand…
  • Shared Services – Richmond, VA
    Today 6hr
    for month end close. AppealsSpecialist - Clinical Appeals The AppealsSpecialist is responsible for performing… tasks for technical appeals: Triage incoming inventory for the Appeals team, validating appeal criteria is met…
  • 2.8
    Universal Health Services – Richmond, VA
    5 days ago 5d
    primary responsibilities of theAppeals Specialist are the resolution of all appeals relating to technical issues identified… The following are the job requirements for the AppealsSpecialist Position: 1. The qualified candidate for this position…
  • 3.6
    Genomic Health – United States
    11 days ago 11d
    Overview The AppealsSpecialist works directly within GHI systems and extensions to address patients, prescribing physicians… status, or on the basis of disability. , AppealsSpecialist Posted Date 3 months ago…
  • PAS – Nashville, TN
    9 days ago 9d
    Summary – The AppealsSpecialist is responsible for performing end to end tasks for technical appeals. Supervisor –Appeals Manager… limited to): Triage incoming inventory for the Appeals team, validating appeal criteria is met Compose technical denial arguments…
  • 3.3
    Aerotek – Pittston, PA
    NEW
    employer in the Pittston, PA area to locate multiple appealspecialists. These will be a first shift position Monday - Friday.… organization. This specialist will be responsible for reviewing case files, researching health care appeals, analyzing all data…
  • 3.1
    Universal American – Houston, TX
    NEW
    Title: AppealsSpecialist Location: Houston, Texas 77081 Job Description: The AppealsSpecialist is a critical… and effective verbal and written communications. The AppealsSpecialist is responsible for the timely assembly of the materials…
  • 4.0
    Equian LLC – Golden, CO
    21 days ago 21d
    The AppealsSpecialist is responsible for three distinct support functions for the Resolution and Appeals Team: Analyzing… Analyzing appeals and resolution matters of a complex nature, and composing/drafting appeal responses and related correspondence. Responsibilities…
  • 4.8
    Morgan Stephens – Long Beach, CA
    EASY APPLY
    NEW
    who are excited to grow and develop a career. A Claims AppealsSpecialist performs detailed review and analysis to investigate audit… discrepancies. Interprets and understands health insurance appeals and provider dispute resolution processes, applicable clinical…
  • 2.9
    Parallon – Norcross, GA
    7 days ago 7d
    limited to): Triage incoming inventory for the Appeals team, validating appeal criteria is met Compose technical denial arguments… and gain commitment for payment through concise and effective appeal argument Identify problem accounts/processes/trends and escalate…
  • 3.5
    Collabera – Sacramento, CA
    9 days ago 9d
    and Medicare claims denials and appeals processing, and knowledge of NCQA guidelines for appeals and denials Description : •… responses. Prepare responses to provider grievances / appeals. Elevates appeals to the appropriate committee and/or manager per protocol…
  • 3.4
    Alls Well Health Care Services – Alameda, CA
    8 days ago 8d
    executes the appeal process for the facilities clinical appeals and third party audit. The Clinical AppealsSpecialist assures clinical… Clinical AppealsSpecialist Position Features: Excellent benefits Full-time Great Pay to $120K The Clinical Appeals Specialist…
  • 3.4
    CareSource (Ohio) – Dayton, OH
    NEW
    Provider AppealsSpecialist City Dayton State OH Description Role and Responsibility: § Review appeals submitted… submitted appeals daily for validation of the appeal § Identify appropriate claim problem within the appeal: corrected…
  • Shared Services – Norcross, GA
    9 days ago 9d
    limited to): Triage incoming inventory for the Appeals team, validating appeal criteria is met Compose technical denial arguments… and gain commitment for payment through concise and effective appeal argument Identify problem accounts/processes/trends and…
  • 2.9
    Parallon – Richmond, VA
    15 days ago 15d
    the 4th for month end close. AppealsSpecialist - Clinical Appeals The AppealsSpecialist is responsible for performing end… end tasks for technical appeals: Triage incoming inventory for the Appeals team, validating appeal criteria is met Compose…
  • 3.4
    CareSource (Ohio) – Dayton, OH
    NEW
    17-1563 Post Date 10/19/2017 Title Grievance & AppealsSpecialist City Dayton State OH Description Role and… Assist members when filling appeals; educate member, document and route the information to Clinical Appeals Coordinator Maintain…
  • 2.6
    VITAS Healthcare – Miami, FL
    9 days ago 9d
    Prepare appeals and claims resubmissions according to health plan requirements. Maintain records of all appeals and documentation… documentation. Follow up with health plans on appeals, research appeal time limits and requirements of health plans. Recommend…
  • 3.3
    Presbyterian Healthcare Services – Albuquerque, NM
    28 days ago 28d
    closely with co-workers Summary: Responsible for tracking, appealing and resolving denied claims, as well as analyzing reimbursements…
  • 3.2
    Kforce – Long Beach, CA
    Today 9hr
    RESPONSIBILITIES: Kforce has a client searching for an AppealsSpecialist I in Long Beach, CA. Essential Functions:… providers Prepare responses to provider grievances/appeals Elevates appeals to the appropriate committee and/or manager per…
  • 3.7
    Hospital for Special Surgery – New York, NY
    16 days ago 16d
    Outpatient AppealsSpecialist is responsible for analyzing, resolving, monitoring and reporting clinical denial and appeals to Denials… Management The Denials Management Outpatient AppealsSpecialist is responsible for appeals and follow-up on clinical denials escalated…
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