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, ...
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...
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...
RCIS Crop Claims Field Adjuster I
Zurich is currently looking for a RCIS Crop Claims Field Adjuster I to join our Rural Community Insurance Services (RCIS) team. Utilize company software to electronically transmit claims information directly from the field to RCIS to ensure claims are processed timely and accurately. The Crop Adjust...
Mechanical Claims Adjuster
In short, as a Claims Adjuster, you will use your knowledge of vehicle systems and repairs to validate, approve, and authorize payment for repair recommendations on warranty claims. DriveTime Family of Brands includes SilverRock, which provides quality warranty and ancillary products, and a customer...
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...