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Problem-solving skills to research and resolve discrepancies, denials, appeals, and collections. Knowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid, and commercial payers.
Full-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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They also provide support and assistance in the preparation and processing of Federal Aviation Administration (FAA) enforcement cases at all stages, up to and including appeals and filing appeal briefs.
$62,858 - $89,796 a yearExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Generous health care benefits on day one PPO, Kaiser (where available), and a High Deductible Health Plan which includes coverage for medical, dental, and vision benefits for employee, spouse, and/or dependent children.
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Knowledge of PPO, HMO, EPO, diagnostic codes, CPT codes, and Medicare/Medicare part D plans. Reviews insurance denials and submit appeals as permitted by payor. Collaborates with other departments to assist in obtaining prior authorizations/appeals.
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Uses knowledge of hospital policy, department procedures, Wisconsin Uniform Billing Regulations (UB04 Mannual), HMO/PPO agreements and other contractual arrangements to maintain accounts receivable, manage commercial payors, and manage appeals.
Full-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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This position will be responsible for real time follow up on all denials, review of open/un-paid PPO Insurance claims, filing appeals and requesting additional needed information for assigned client offices.
Full-timeExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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Strong candidates will have hands-on experience in all phases of litigation including law and motion, depositions, trial and appeals and should be proficient in oral and written advocacy. Employer−subsidized health benefits include Medical (PPO), Dental, Vision, Life Insurance, Long-term Disability, 401(k) & matching.
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The Grievance/Appeals Analyst I is an entry level position in the Enterprise Grievance & Appeals Department that reviews, analyzes and processes non-complex pre service and post service grievances and appeals requests from customer types (i.e. member, provider, regulatory and third party) and multiple products (i.e. HMO, POS, PPO, EPO, CDHP, and indemnity) related to clinical and non clinical services, quality of service, and quality of care issues to include executive and regulatory grievances.
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This will involve providing quality control checks on paper claims; processing tracers, denials and related correspondence; initiating appeals; and drafting, composing, and submitting appeal letters.
$26.85 - $35.41 an hourExpandUpdated 7 days ago - UpvoteDownvoteShare Job
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Is an entry level position in the Enterprise Grievance & Appeals Department that reviews, analyzes and processes non-complex pre service and post service grievances and appeals requests from customer types (i.e. member, provider, regulatory and third party) and multiple products (i.e. HMO, POS, PPO, EPO, CDHP, and indemnity) related to clinical and non clinical services, quality of service, and quality of care issues to include executive and regulatory grievances.
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As a Dental Billing specialist you will be responsible for submitting claims and attachments to insurance companies, filing appeals and collecting outstanding insurance claims for our clients. We offer a Capital Blue Cross PPO Health Insurance Plan with employer contribution, Paid Dental and Vision plans, 6 paid holidays and up to two weeks of.
ExpandApply NowActive JobUpdated 9 days ago - UpvoteDownvoteShare Job
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Responsible for ensuring timely filing and guidelines are met; provided quality control checks on paper and electronic claims; process tracers, denial and related correspondence; initiate appeals; compose and submit appeal letters specific challengeable denial issues consistent with the most update American Medical Association Current Procedural Terminology.
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HSA and PPO insurance with HSA or FSA options (Blue Cross Blue Shield) Work with the Utilization Review team to provide psychiatric information to support the facilitation of peer-to-peer insurance reviews, determination of appropriate levels of care, arbitration of clinical appeals, etc.
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The Biller is responsible to bill all insurance companies, workers� compensation carriers, as well as HMO/PPO carriers. Is able to write effective appeals to insurance companies. Able to identify stop loss claims, implants and missing codes.
Full-timeExpandApply NowActive JobUpdated 23 days ago - UpvoteDownvoteShare Job
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Title: Grievance/Appeals Analyst I. Grievance/Appeals Analyst I. Reviews, analyzes and processes non-complex grievances and appeals in accordance with external accreditation and regulatory requirements, internal policies and claims events requiring adaptation of written response in clear, understandable language.
ExpandApply NowActive JobUpdated 9 days ago
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