A company is looking for a Medicare Claims Appeals and Grievances Specialist.Key ResponsibilitiesReview and resolve member and provider complaints in compliance with CMS standardsResearch claims appeals and grievances, including medical records and billing detailsPrepare written responses and appeal summaries while ensuring regulatory complianceRequired QualificationsHigh School Diploma or equivalentMinimum 2 years of operational managed care experienceHealth claims processing background, including coordination of benefits and eligibility criteriaFamiliarity with Medicaid and Medicare claims denials and appeals processing
Medicare Claims Appeals Specialist
A company is looking for a Medicare Claims Appeals and Grievances Specialist. ...
Unemployment Claims Appeals Specialist
A company is looking for an Unemployment Claims Appeals Specialist to assist with resolving vendor inquiries and remitting information to state agencies. ...
Senior Bodily Injury Claims Adjuster
A company is looking for a Senior Bodily Injury Claims Adjuster to handle various aspects of injury claims resulting from personal auto losses. ...
Specialty/Commercial Casualty Claims Specialist - Remote
As a Commercial/Specialty Casualty Adjuster, you will be responsible to resolve all aspects of 1st and 3rd party injury claims of low to moderate complexity for personal lines as well as our commercial claims. Handle 1st party exposures to include Medical Payment coverage, PIP, Uninsured Motorists, ...
Billing Specialist
Assist with initiating and implementing of all aspects of the monthly client billing process including:. Maintain telephone and personal contact with clients, attorneys and staff on billing matters. Compile necessary back-up documentation per client billing guidelines. Manage monthly reports surroun...
Field Claims Adjuster
Join EAC Claims Solutions as a Property Field Adjuster, where you will be managing insurance claims from inception to resolution. At EAC Claims Solutions, we are dedicated to resolving claims with integrity and efficiency. Planning and organizing daily workload to process claims and conduct inspecti...
Crop Claims Seasonal Adjuster
Physical Requirements for employees in the Crop Business Unit/Crop Claims General Adjuster. Great American is currently seeking Seasonal Crop Adjusters, q. Understand and can work claims for all major crops, policy/plan types, in all stages of growth. Works toward the resolution of claims files, and...
Medical Billing Specialist
Monthly claims billing; follow-up, re-billing, secondary billing and correction billing of claims. Each Billing Specialist is assigned the responsibility of working accounts and keeping the account receivables within department standards. The Billing Specialist needs to have the ability to multi-tas...
Claims Clinical Specialist – Medical Review Team
Claims Clinical Specialist – Medical Review Team. The Claims Clinical Specialist role is an excellent opportunity for a Registered Nurse seeking a career change. You will be responsible for working within a structured environment with established Standard Operating Procedures to ensure consistency o...
Billing Specialist (Man. Road)
The Billing Specialist will coordinate quality assurance of transactional activities related billing. Job Title Billing Specialist (Man. The Billing Specialist is required to review all processed customer invoices for validation. Escalate and/or resolve customer billing inquiries or issues in a time...