CLINICAL APPEALS SPECIALIST jobs in UNITED STATES, United Kingdom

in the United States for this remote role.) Xtend Healthcare is looking for aClinical Appeals Specialist, RN who... and obtain medical documentation required to facilitate denial appeals process. Upon direction of the Xtend Project leader...

Job Description: Additional Information About the Role BJC is seeking a Clinical Appeals Specialist for a remote... hospitals and payors. The Clinical Appeals Specialist must be able to multi-task and maintain a high level of professionalism...

: The Clinical Appeals and Denials Support Specialist (CADSS) will report to the Manager of Appeals & Peer to Peer... record for appeal writer. Provide as needed administrative and operational support for the Clinical Support Specialist. The...

Overview Resolves grievances, appeals and external reviews for one of the following VNS Health Plans product lines... or appeal decision. Develops correspondence communicating the outcome of grievances and appeals to enrollees and/or providers...

and appeals in a manner that diligently investigates every unpaid claim Assesses the need for formal appeals of all clinical... clinical documentation to ensure its sufficiency Utilizes various resources in order to understand the appeals and denials...

Summary of Position We are seeking a talented Grievance & Appeals Specialist who will be responsible for responding... to written/verbal grievances, complaints, appeals, and disputes submitted by members and providers in accordance with NCQA, CMS...

medical policies. The As a lead position, lead appeals and denial specialist this role will additional support the leads the... with 1-2 days in office Summary Responsible for performing advanced level work related to appeals and denials by conducting...

for coordinating and appealing technical denials and working closely with the HIM Appeals Specialist responsible for clinical appeals... work on appealed claims. Works with insurance carriers on appeal issues. Ensure clinical appeals are submitted to the HIM...

Clinical Appeals and Analysis Unit 2 years as Appeals Specialist II Preferred Qualifications: College Degree Knowledge...Job Title: Appeals Specialist III / Member Service Rep III Client: Health Care Insurance Duration: 4 Months...

of individuals eligible for cancer screening. Job Description As a Reimbursement Specialist – Follow Up and Appeals, you play... leverages capabilities to drive commercial adoption, improve patient clinical outcomes and lower healthcare costs...

As the Specialist, Grievances and Appeals you will be responsible for participating in the day-to-day operations of the... Clinical Grievances and Appeals team. Under the direction of the Interim Supervisor of Grievances and Appeals, you will help...

Specialist integrates medical coding principles and objectivity in the performance of coding appeals activities. Draws on ICD10CM... billing/coding issues, and quality concerns. Under indirect supervision, the Coding Appeals Specialist is responsible...

The Customer Solution Center Appeals and Grievances Nurse Specialist LVN II is primarily responsible for the overall... to appropriately investigate, review and resolve clinical appeals and grievances. Prepares Nurse Summary for MD review...

Options) As a Reimbursement Specialist, Follow Up and Appeals, you play an important role in the overall success of the... leverages capabilities to drive commercial adoption, improve patient clinical outcomes and lower healthcare costs...

Summary of Position We are seeking a talented Grievance & Appeals Specialist who will be responsible for responding... to written/verbal grievances, complaints, appeals, and disputes submitted by members and providers in accordance with NCQA, CMS...

The Customer Solution Center Appeals and Grievances Quality Auditing (QA) Specialist II is responsible for assisting the... of productivity and focus on implementing, executing, tracking, and assessing targeted and random audits for non-clinical grievance...

Appeals Specialist is responsible for monitoring and tracking the status of appeals submitted by the Clinical Appeals... and support to the Clinical Appeals Representative and the Revenue Integrity Coordinator. The Appeals Specialist requires...