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Healthcare Claims Denials And Appeals Specialist Jobs in Gwinnett, Georgia

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 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 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 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 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 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 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.
Insurance Follow-Up/Denials And Appeals Rep
By Prestige Staffing At Atlanta, GA, United States
At least 5+ years Healthcare Revenue Cycle experience
Must have experience with Medical Insurance Follow-up, Denials/Appeals and Payment Posting
Must have experience with a large EMR system (Epic, Next Gen, Cerner, etc.)
Must have outstanding written and verbal communication skills
COVID Vaccine is required. Declination forms accepted.
Must have worked inpatient claims in a recent role (UB04 forms)
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.
Hospital Denials/Medical Appeals Specialist
By Beth Israel Lahey Health At Burlington, MA, United States
To be eligible, you must be a non-BILH employee or a previous eligible employee who returns to BILH after 1 year.
Previous employees returning within 1-Year are eligible for a retention bonus.
Employee must be in good standing to receive the bonus at the time of payment.
All bonuses are subject to applicable taxes. This program is subject to change at any point
Insurance Denials Specialist Jobs
By Artius Solutions At United States
If candidate does not have EPIC experience, state what electronic medical record system they are using for working current denials.
Reviews all patient complaints and works to ensure a positive customer service experience by fully answering patient queries
Reviews denial reasons, validates accurate coding, and initiates appeals process for claims to ensure prompt and accurate payment.
Works to understand denial reason using provided information from payer
Collaborates with coding team, as needed, to ensure understanding of initial code selection and if updates are required
Researches payer-specific coverage policies to determine if an appeal is warranted
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 ...

Denials And Appeals Specialist - Patient Financial Services - F/T Days
By UC Irvine Health At , Anaheim $28.61 - $35.58 an hour
Advanced knowledge of revenue cycle processes gained from previous related work experience in a healthcare setting
Demonstrated experience in CPT, HCPC and ICD billing codes, authorization requirements and related documentation
Effective data and numerical data entry skills
Must possess the skill, knowledge and ability essential to the successful performance of assigned duties
Advanced knowledge of a variety of non-governmental and governmental payers
Skilled at using computerized systems and applications to maintain/update patient accounting information
Rn Denials Specialist Jobs
By Ensemble Health Partners At , Remote
Case Management or Utilization Review experiences strongly preferred
Knowledge of patient insurance process and requirements preferred
2+ years of experience in an acute care hospital direct patient care setting required
Identifying the root cause for clinical claim denial
Reviewing medical records against nationally recognized clinical criteria guidelines (Interqual, MCG, NCD/LCD,DCA, etc.)
Using clinical decision making to determine the appropriate actions needed to recover or defend revenue
Denials/Medical Appeals Specialist
By Lahey Health Shared Services At , Burlington, Ma
Required Education: High School Diploma
Preferred Licensure, Certification & Registration: Medical Billing Certification
-To be eligible, you must be a non-BILH employee or a previous eligible employee who returns to BILH after 1 year.
-Previous employees returning within 1-Year are eligible for a retention bonus.
-Employee must be in good standing to receive the bonus at the time of payment.
-All bonuses are subject to applicable taxes. This program is subject to change at any point
Claims Specialist - Healthcare
By Talently Recruiting At Illinois, United States
Prepare reports for management by collecting, analyzing, and summarizing claim information.
Maintain proper file documentation of assigned files by complying with company and state requirements.
2+ years of experience in the legal or medical field.
Experience with Professional Liability preferred.
Responsibilities include, but are not limited to:
Actively engage in review processes to evaluate liability, assess case value, and oversee reserving functions and total claims costs.
Accounts Receivable Representative, Denials And Appeals, Remote
By Providence At , , Wa

2 years Experience in automated, computerized account follow-up system in a hospital setting, health insurance claims processing or medical office

Check out our benefits page for more information about our Benefits and Rewards.

Accounts Receivable Representative, Denials And Appeals, Remote
By Providence At , , Tx

2 years Experience in automated, computerized account follow-up system in a hospital setting, health insurance claims processing or medical office

Check out our benefits page for more information about our Benefits and Rewards.

Accounts Receivable Representative, Denials And Appeals, Remote
By Providence At , , Nm

2 years Experience in automated, computerized account follow-up system in a hospital setting, health insurance claims processing or medical office

Check out our benefits page for more information about our Benefits and Rewards.

Healthcare Claims Specialist Jobs
By Health Advocate At , Remote From $20 an hour
Exercise exceptional customer service skills in an effort to optimize each contact with the member
Minimum of one year customer service, healthcare, or claims processing experience required.
Basic Knowledge of MS Word and Excel required
Group Benefits (Fully Insured vs. Self-Insured)
Medical Benefits (CDHP/HDHP, PPO, POS, and HMO Plans)
Ability to interpret Explanation of Benefits (EOBs).
Clinical Denials & Appeals Specialist (Registered Nurse) Remote
By Northwell Health At , Melville, 11747, Ny $78,000 - $130,000 a year

Remote Work Schedule: Sun-Thurs/8:30AM - 4:30PM

Rn Specialist-Denials And Appeals
By Ascension At , Batavia, 60510, Il
May educate case management staff and other departments regarding payer changes and denial/appeal process.
Use clinical and coding knowledge to ensure accurate and compliant charge items and to recognize and resolve billing inconsistencies.
Collaborate with managed care department to code billable items for reimbursement.
Licensure / Certification / Registration:
Hospital: Alexian Brothers Health System
Establishe and maintain positive and cooperative relationships with medical staff and care coordination leaders to ensure ongoing compliance with utilization review guidelines.
Hospital Denials/Medical Appeals Specialist
By Beth Israel Lahey Health At , Burlington, Ma
Required Education: High School Diploma
Preferred Licensure, Certification & Registration: Medical Billing Certification
-Bonuses are paid out within the first 30 days of hire.
-To be eligible, you must be a non-BILH employee or a previous eligible employee who returns to BILH after 1 year.
-Previous employees returning within 1-Year are eligible for a retention bonus.
-Employee must be in good standing to receive the bonus at the time of payment.
Provider Non-Contracted Appeals And Claims Analyst
By Mediant Health Resources At Los Angeles, CA, United States
Proven problem-solving skills and ability to translate knowledge to the department
3+ years’ experience processing Medicare Advantage provider appeals from all types of providers (hospitals, physicians, ancillary)
3+ years’ experience in examining all types of medical claims, preferably Medicare Advantage claims
Working knowledge of claims processing systems (EZCAP preferred)
Working knowledge of medical terminology, standard coding and reference publications, CPT, HCPC, ICD-9, ICD-10, DRG, etc.
Familiarity with billing and coding edits, coordination of benefits, MA Organization, Determination, Appeals and Grievance procedures
Grievances And Appeals Specialist
By Papa At United States
Ability to work under pressure and within time constraints – excellent time management and prioritization skills are needed.
Intake and management of complex complaints from senior citizens from multiple categories including safety.
Coordinates additional follow up outreach as needed to conclude an investigation and will ensure appropriate departmental communication with managers.
Demonstrates appropriate customer-care skills such as empathy, active listening, courtesy, politeness, helpfulness, and other skills as identified.
Strong written and verbal communication skills and an ability to work with people from diverse backgrounds displaying compassion, empathy and understanding.
1 year of Grievance and appeals experienced preferred
Clinical Payment Resolution Specialist (Hospital Denials & Appeals) - Pfs (Remote)
By Trinity Health At Farmington Hills, MI, United States
Coordinates rejection, denial and appeal activities with Ministry Organization (MO) based Utilization Review/Case Management departments;
Supports the maintenance of a denial management data base, standard report sets, letter template and other key job aids.
Assists in marketing efforts and the education of physicians, physician office staff and MO colleagues;
Reviews and understands utilization review and coverage guidelines for multiple payers;
Establishes checks and balances to ensure PBS and MO-based key performance indicators are accurate and that goals/targets are met, and