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.
Healthcare Claims Denials And Appeals Specialist
By CenterWell Senior Primary Care At Marietta, 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.

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