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Healthcare Claims Appeals Specialist Jobs

Appeals Specialist Jobs
By BlueCross BlueShield of South Carolina At Augusta, GA, United States
Excellent organizational, customer service, and written and verbal communication skills.
Proficiency in spelling, punctuation, and grammar skills.
Perform non-medical reviews and process redetermination letters ensuring timeliness and accuracy.
Prepare unit reports, analyze, and interpret workload, and process issues utilizing various software tools.
Update letters and documents within the department when necessary.
May gather and prepare documentation for legal inquiries and administrative requests.
Rcm Healthcare Claims Denials Specialist
By CenterWell Home Health At Cumming, GA, United States
Minimum of two years medical claims processing experience
Knowledge of healthcare collection procedures and microcomputer software/hardware
Effective analytical and communication skills
Ensure the coordination of claim activities and designated agencies, and the timely reimbursement of receivables.
Research, resolve, and prepare claims that have not passed the payer edits daily. Determine and initiate action to resolve rejected invoices.
Analyze each agency's outstanding monthly accounts receivable, and process claims to obtain zero balances.
Rcm Healthcare Claims Denials Specialist
By CenterWell Home Health At Duluth, GA, United States
Minimum of two years medical claims processing experience
Knowledge of healthcare collection procedures and microcomputer software/hardware
Effective analytical and communication skills
Ensure the coordination of claim activities and designated agencies, and the timely reimbursement of receivables.
Research, resolve, and prepare claims that have not passed the payer edits daily. Determine and initiate action to resolve rejected invoices.
Analyze each agency's outstanding monthly accounts receivable, and process claims to obtain zero balances.
Rcm Healthcare Claims Denials Specialist
By CenterWell Home Health At Acworth, GA, United States
Minimum of two years medical claims processing experience
Knowledge of healthcare collection procedures and microcomputer software/hardware
Effective analytical and communication skills
Ensure the coordination of claim activities and designated agencies, and the timely reimbursement of receivables.
Research, resolve, and prepare claims that have not passed the payer edits daily. Determine and initiate action to resolve rejected invoices.
Analyze each agency's outstanding monthly accounts receivable, and process claims to obtain zero balances.
Rcm Healthcare Claims Denials Specialist
By CenterWell Home Health At Smyrna, GA, United States
Minimum of two years medical claims processing experience
Knowledge of healthcare collection procedures and microcomputer software/hardware
Effective analytical and communication skills
Ensure the coordination of claim activities and designated agencies, and the timely reimbursement of receivables.
Research, resolve, and prepare claims that have not passed the payer edits daily. Determine and initiate action to resolve rejected invoices.
Analyze each agency's outstanding monthly accounts receivable, and process claims to obtain zero balances.
Rcm Healthcare Claims Denials Specialist
By CenterWell Home Health At Avondale Estates, GA, United States
Minimum of two years medical claims processing experience
Knowledge of healthcare collection procedures and microcomputer software/hardware
Effective analytical and communication skills
Ensure the coordination of claim activities and designated agencies, and the timely reimbursement of receivables.
Research, resolve, and prepare claims that have not passed the payer edits daily. Determine and initiate action to resolve rejected invoices.
Analyze each agency's outstanding monthly accounts receivable, and process claims to obtain zero balances.
Rcm Healthcare Claims Denials Specialist
By CenterWell Home Health At Stone Mountain, GA, United States
Minimum of two years medical claims processing experience
Knowledge of healthcare collection procedures and microcomputer software/hardware
Effective analytical and communication skills
Ensure the coordination of claim activities and designated agencies, and the timely reimbursement of receivables.
Research, resolve, and prepare claims that have not passed the payer edits daily. Determine and initiate action to resolve rejected invoices.
Analyze each agency's outstanding monthly accounts receivable, and process claims to obtain zero balances.
Rcm Healthcare Claims Denials Specialist
By CenterWell Home Health At Decatur, GA, United States
Minimum of two years medical claims processing experience
Knowledge of healthcare collection procedures and microcomputer software/hardware
Effective analytical and communication skills
Ensure the coordination of claim activities and designated agencies, and the timely reimbursement of receivables.
Research, resolve, and prepare claims that have not passed the payer edits daily. Determine and initiate action to resolve rejected invoices.
Analyze each agency's outstanding monthly accounts receivable, and process claims to obtain zero balances.
Rcm Healthcare Claims Denials Specialist
By CenterWell Home Health At Alpharetta, GA, United States
Minimum of two years medical claims processing experience
Knowledge of healthcare collection procedures and microcomputer software/hardware
Effective analytical and communication skills
Ensure the coordination of claim activities and designated agencies, and the timely reimbursement of receivables.
Research, resolve, and prepare claims that have not passed the payer edits daily. Determine and initiate action to resolve rejected invoices.
Analyze each agency's outstanding monthly accounts receivable, and process claims to obtain zero balances.
Rcm Healthcare Claims Denials Specialist
By CenterWell Home Health At Suwanee, GA, United States
Minimum of two years medical claims processing experience
Knowledge of healthcare collection procedures and microcomputer software/hardware
Effective analytical and communication skills
Ensure the coordination of claim activities and designated agencies, and the timely reimbursement of receivables.
Research, resolve, and prepare claims that have not passed the payer edits daily. Determine and initiate action to resolve rejected invoices.
Analyze each agency's outstanding monthly accounts receivable, and process claims to obtain zero balances.
Rcm Healthcare Claims Denials Specialist
By CenterWell Home Health At Roswell, GA, United States
Minimum of two years medical claims processing experience
Knowledge of healthcare collection procedures and microcomputer software/hardware
Effective analytical and communication skills
Ensure the coordination of claim activities and designated agencies, and the timely reimbursement of receivables.
Research, resolve, and prepare claims that have not passed the payer edits daily. Determine and initiate action to resolve rejected invoices.
Analyze each agency's outstanding monthly accounts receivable, and process claims to obtain zero balances.
Rcm Healthcare Claims Denials Specialist
By CenterWell Home Health At Norcross, GA, United States
Minimum of two years medical claims processing experience
Knowledge of healthcare collection procedures and microcomputer software/hardware
Effective analytical and communication skills
Ensure the coordination of claim activities and designated agencies, and the timely reimbursement of receivables.
Research, resolve, and prepare claims that have not passed the payer edits daily. Determine and initiate action to resolve rejected invoices.
Analyze each agency's outstanding monthly accounts receivable, and process claims to obtain zero balances.
Rcm Healthcare Claims Denials Specialist
By CenterWell Home Health At Clarkston, GA, United States
Minimum of two years medical claims processing experience
Knowledge of healthcare collection procedures and microcomputer software/hardware
Effective analytical and communication skills
Ensure the coordination of claim activities and designated agencies, and the timely reimbursement of receivables.
Research, resolve, and prepare claims that have not passed the payer edits daily. Determine and initiate action to resolve rejected invoices.
Analyze each agency's outstanding monthly accounts receivable, and process claims to obtain zero balances.
Appeals Specialist Jobs
By BlueCross BlueShield of South Carolina At Columbia, SC, United States
Required Education: High School Diploma or equivalent
Required Work Experience: Two (2) years of job related experience (healthcare, insurance, banking or call center).
Our Comprehensive Benefits Package Includes
Eligible for up to a $2400 annual bonus.
Performs non-medical reviews and processes redetermination letters ensuring timeliness and accuracy.
Prepares unit reports, analyzes and interprets workload, and processes issues utilizing various software tools.
Healthcare Appeals/Denials Coordinator - Remote | Wfh
By Get It Recruit - Healthcare At Los Angeles, CA, United States

Are you passionate about making a difference in the healthcare industry? Do you thrive in a dynamic environment where your skills are valued? We are currently seeking a dedicated Healthcare ...

Healthcare Claims Specialist - Remote | Wfh
By Get It Recruit - Healthcare At Little Rock, AR, United States

We are a dynamic organization seeking a skilled and dedicated Medical Claims Specialist to join our team for a remote contract position. With a strong possibility of extension, we offer a rewarding ...

Appeals Specialist Jobs
By Kepro At Cary, NC, United States
Do you value care management and quality improvement?
Are you an experienced Appeals Specialist looking for a new challenge?
Excellent verbal and written communication skills.
Requires 3+ years’ customer service experience.
Previous experience in the health care industry preferred
Are you motivated, energetic, and excited to become part of the Kepro team?
Appeals & Support Specialist Jobs
By County of Dallas Tax Appraisal District At , Dallas, 75247 $32,000 - $49,653 a year
Previous customer service, appraisal office, or other office experience.
Bilingual in Spanish - (read and speak) is preferred.
Salary Range: $32,000 to $49,653 DOE
Healthcare Claims Support Associate
By CareCentrix At , Remote
Knowledge of basic spreadsheet / word processing / data entry and basic math skills required.
Knowledge of Claims Management and URAC standards preferred.
Tracks claim detail errors and communicates to up-line management for coaching and training purposes.
Must have minimum 1 year work experience.
Two years of customer service, claims processing, medical terminology, medical services or equivalent experience required.
Full range of benefits including Health, Dental and Vision with HSA Employer Contributions and Dependent Care FSA Employer Match.
Healthcare Claims Support Associate
By CareCentrix At United States
Knowledge of basic spreadsheet / word processing / data entry and basic math skills required.
Knowledge of Claims Management and URAC standards preferred.
Tracks claim detail errors and communicates to up-line management for coaching and training purposes.
Must have minimum 1 year work experience.
Two years of customer service, claims processing, medical terminology, medical services or equivalent experience required.
Full range of benefits including Health, Dental and Vision with HSA Employer Contributions and Dependent Care FSA Employer Match.

Are you looking for an exciting opportunity to make a difference in the healthcare industry? We are seeking a Healthcare Claims Appeals Specialist to join our team and help ensure that our clients receive the best possible care. As a Claims Appeals Specialist, you will be responsible for reviewing and resolving denied claims, communicating with insurance companies, and providing guidance to our clients. If you have a passion for helping others and a commitment to excellence, this could be the perfect job for you!

Overview:

A Healthcare Claims Appeals Specialist is responsible for reviewing and processing appeals related to healthcare claims. They must be knowledgeable in healthcare regulations and policies, and must be able to interpret and apply them to appeals. They must also be able to effectively communicate with providers, patients, and other stakeholders.

Detailed Job Description:

A Healthcare Claims Appeals Specialist is responsible for reviewing and processing appeals related to healthcare claims. They must be knowledgeable in healthcare regulations and policies, and must be able to interpret and apply them to appeals. They must also be able to effectively communicate with providers, patients, and other stakeholders. They must be able to review and analyze medical records, claims, and other documents to determine the validity of the appeal. They must also be able to make decisions regarding the appeal and communicate the decision to the appropriate parties.

What is Healthcare Claims Appeals Specialist Job Skills Required?

• Knowledge of healthcare regulations and policies
• Ability to interpret and apply regulations and policies to appeals
• Ability to review and analyze medical records, claims, and other documents
• Ability to make decisions regarding appeals
• Effective communication skills
• Organizational skills
• Problem-solving skills

What is Healthcare Claims Appeals Specialist Job Qualifications?

• Bachelor’s degree in healthcare administration, business administration, or a related field
• At least 2 years of experience in healthcare claims processing
• Knowledge of healthcare regulations and policies
• Ability to interpret and apply regulations and policies to appeals
• Ability to review and analyze medical records, claims, and other documents
• Ability to make decisions regarding appeals
• Effective communication skills
• Organizational skills
• Problem-solving skills

What is Healthcare Claims Appeals Specialist Job Knowledge?

• Knowledge of healthcare regulations and policies
• Knowledge of medical terminology
• Knowledge of medical coding
• Knowledge of healthcare claims processing
• Knowledge of appeals process

What is Healthcare Claims Appeals Specialist Job Experience?

• At least 2 years of experience in healthcare claims processing
• Experience in appeals processing
• Experience in customer service

What is Healthcare Claims Appeals Specialist Job Responsibilities?

• Review and process appeals related to healthcare claims
• Interpret and apply healthcare regulations and policies to appeals
• Review and analyze medical records, claims, and other documents
• Make decisions regarding appeals
• Communicate decisions to providers, patients, and other stakeholders
• Ensure compliance with healthcare regulations and policies
• Provide customer service to providers, patients, and other stakeholders