Talent.com
Appeals Representative
Appeals RepresentativeVirtualVocations • Astoria, New York, United States
Appeals Representative

Appeals Representative

VirtualVocations • Astoria, New York, United States
job_description.job_card.30_days_ago
serp_jobs.job_preview.job_type
  • serp_jobs.job_card.full_time
job_description.job_card.job_description

A company is looking for an Appeals Representative to handle provider appeals and related tasks.

Key Responsibilities

Classify, research, and understand providers' intent to appeal decisions

Status providers as participating or non-participating and route appeals accordingly

Identify and obtain additional information needed to assess provider intent

Required Qualifications

High School Diploma / GED or equivalent work experience

Must be 18 years of age or older

1+ years of experience in analyzing and solving customer problems or related work experience

Proficiency with computer and Windows PC applications

Ability to work full-time (40 hours / week) with flexibility during normal business hours

serp_jobs.job_alerts.create_a_job

Representative • Astoria, New York, United States

Job_description.internal_linking.related_jobs
Oregon Licensed Clinical Appeals Coordinator

Oregon Licensed Clinical Appeals Coordinator

VirtualVocations • Jackson Heights, New York, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Appeals Coordinator.Key Responsibilities Act as a liaison for statewide appeals and ensure compliance with State and NCQA requirements Review clinical informa...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Mortgage Sales Enablement Partner

Mortgage Sales Enablement Partner

VirtualVocations • Elizabeth, New Jersey, United States
serp_jobs.job_card.full_time
A company is looking for a Mortgage Sales Enablement Partner responsible for managing and scaling a comprehensive Sales Management Task Force. Key Responsibilities Manage and scale a comprehensive...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Texas Licensed Hospital Collector

Texas Licensed Hospital Collector

VirtualVocations • Flushing, New York, United States
serp_jobs.job_card.full_time
A company is looking for a Hospital AR Collector - Level III.Key Responsibilities : Conducts in-depth reviews and timely follow-ups on high-dollar accounts to ensure claim resolution and maximum r...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Claimant Side Workers' Compensation Attorney

Claimant Side Workers' Compensation Attorney

Jobot • New York, NY, US
serp_jobs.job_card.full_time
This Jobot Job is hosted by : Farrell Ougheltree.Are you a fit? Easy Apply now by clicking the "Apply Now" buttonand sending us your resume. Salary : $150,000 - $210,000 per year.Our client ...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Entry Level Appeals Specialist

Entry Level Appeals Specialist

VirtualVocations • Flushing, New York, United States
serp_jobs.job_card.full_time
A company is looking for an Associate Specialist, Appeals & Grievances - Remote.Key Responsibilities Enter denials and requests for appeals into the information system and prepare documentation f...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
Grievance and Appeals Coordinator

Grievance and Appeals Coordinator

VirtualVocations • Newark, New Jersey, United States
serp_jobs.job_card.full_time
A company is looking for a Grievance & Appeals Coordinator.Key Responsibilities Analyze and resolve claims and authorization appeals from providers and formal grievances from members Prepare res...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Appeals Representative

Appeals Representative

VirtualVocations • Paterson, New Jersey, United States
serp_jobs.job_card.full_time
A company is looking for an Appeals Representative to handle provider appeals and related tasks.Key Responsibilities Classify, research, and understand providers' intent to appeal decisions Stat...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Insurance Follow Up Representative

Insurance Follow Up Representative

VirtualVocations • Jamaica, New York, United States
serp_jobs.job_card.full_time
A company is looking for an Insurance Follow Up Representative to manage outstanding insurance claims and ensure timely payments. Key Responsibilities Contact insurance carriers and patients to ob...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_1_day • serp_jobs.job_card.promoted
Expedited Appeals Specialist

Expedited Appeals Specialist

EmblemHealth • New York, NY, United States
serp_jobs.job_card.full_time
Responsible for processing expedited appeals : those that are complex in nature, require multiple hand-offs, and tend to have extremely tight deadlines. Ensure accuracy and compliance within the cons...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Medicare Appeals Specialist

Medicare Appeals Specialist

VirtualVocations • Jackson Heights, New York, United States
serp_jobs.job_card.full_time
A company is looking for a Full-Time, Temporary Appeals and Grievances Specialist.Key Responsibilities Make independent decisions on Member Appeals impacting overall performance and CMS scoring ...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Senior Disability Appeals Consultant

Senior Disability Appeals Consultant

VirtualVocations • Jamaica, New York, United States
serp_jobs.job_card.full_time
A company is looking for a Sr Disability Appeals Consultant responsible for managing and adjudicating appeals related to adverse claim determinations of disability and leave benefits.Key Responsibi...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_1_day • serp_jobs.job_card.promoted
State Licensed Complex Loss Specialist

State Licensed Complex Loss Specialist

VirtualVocations • Paterson, New Jersey, United States
serp_jobs.job_card.full_time
A company is looking for a Complex Loss Specialist.Key Responsibilities Adjust complex and high exposure losses requiring technical expertise and negotiation Build and maintain productive relati...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_1_day • serp_jobs.job_card.promoted
Mortgage Inside Sales Representative

Mortgage Inside Sales Representative

VirtualVocations • Flushing, New York, United States
serp_jobs.job_card.full_time
A company is looking for a Mortgage Inside Sales Representative (Outbound Call Center) to work from home.Key Responsibilities Manage a high volume of calls with existing or potential homeowners ...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
MD Appeals Medical Director

MD Appeals Medical Director

VirtualVocations • Paterson, New Jersey, United States
serp_jobs.job_card.full_time
A company is looking for an Appeals M.Member Appeals to perform clinical reviews and adjudications of appeals and grievances cases. Key Responsibilities Conduct individual case reviews for appeals...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Claims Representative

Claims Representative

VirtualVocations • Jamaica, New York, United States
serp_jobs.job_card.full_time
A company is looking for a Claims Representative to provide support in processing and managing health care claims.Key Responsibilities Review, research, investigate, negotiate, process, and adjus...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Appeals Manager

Appeals Manager

BronxCare Health System • Bronx, NY, US
serp_jobs.job_card.full_time
The Appeals Manager is responsible to assist in the analysis and preparation of response to denial notification letters that arrive in letter and electronic format. Collaborating with the Department...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Complaint and Appeals Coordinator

Complaint and Appeals Coordinator

VirtualVocations • Paterson, New Jersey, United States
serp_jobs.job_card.full_time
A company is looking for a Coordinator, Complaint & Appeals - Work From Home.Key Responsibilities Manage resolution of complaint / appeal scenarios across multiple business units Ensure timely, cu...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Cash Applications Representative

Cash Applications Representative

VirtualVocations • Newark, New Jersey, United States
serp_jobs.job_card.full_time
A company is looking for a Cash Apps Representative I to manage cash application processes and improve financial performance. Key Responsibilities Minimize Days Sales Outstanding (DSO) and manage ...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Malpractice Litigation Attorneys - All Levels

Malpractice Litigation Attorneys - All Levels

Jobot • Red Bank, NJ, US
serp_jobs.job_card.full_time
Malpractice Litigation Attorneys (All Levels) – NYC Metro | Top Malpractice Defense Firm! ????⚖️.This Jobot Job is hosted by : Andrew Harrison. Are you a fit? Easy Apply now by cl...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Utilization Review Appeals Specialist

Utilization Review Appeals Specialist

VirtualVocations • New York, New York, United States
serp_jobs.job_card.full_time
A company is looking for a Utilization Rev Appeals Specialist.Key Responsibilities Review patient medical records to determine reasons for denials and required appeals Collaborate with various d...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted