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We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
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Makes medical necessity determinations for grievance and appeals appropriate for their specialty. The Clinical Operations Associate Medical Director responsible for supporting the medical management staff ensuring timely and consistent medical decisions to members and providers.
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Utilizes clinical expertise, and reviews insurance appeals, prospective and retrospective claims. The Physician Reviewer will provide an interpretation of the medical necessity of services provided by other healthcare professionals in compliance with client specific policies, nationally recognized evidence-based guidelines, and standards of care.
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Successful completion of the program in medical billing; current Certified Medical Reimbursement Specialist (CMRS) certification; or Associates Degree in Business Administration, Accounting, or Health Care Administration may be preferred or required.
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The Intake Coordinator is responsible for obtaining complete and accurate patient insurance verification and authorization to support the provision of care and services. Submits appeals for authorization denials.
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Significant experience structuring and administering healthcare plans (medical and dental insurance), welfare plans (life and disability insurance) and cafeteria plans in compliance with the requirements of ERISA, COBRA, HIPAA, the Americans With Disabilities Act and the Family and Medical Leave Act (FMLA.
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The anticipated starting salary is $160,000 +/- DOQ. A comprehensive benefits package includes participation in the Illinois Municipal Retirement Fund (IMRF), health insurance including medical, dental, and vision coverage (also available to dependents), flexible spending account, and life insurance.
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Competitive compensation based on experience Medical insurance plan Dental insurance plan Vision insurance plan Contribution to life insurance plan 401k profit sharing Parking reimbursement Social, charity and wellness events.
$20 - $30 an hourFull-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Perform individual case review for appeals and grievances for various health plan and insurance products, which may include PPO, ASO, HMO, MAPD, and PDP. The appeals are in response to adverse determinations for medical services related to benefit design and coverage and the application of clinical criteria of medical policies.
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This will be a 100-bed combined critical illness recovery and inpatient rehabilitation hospital with 44 critical illness recovery and 56 inpatient rehabilitation beds on the RUSH University Medical Center campus.
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Ability to complete benefits investigations as needed, review insurance denials and submit appeals when needed, prioritize workload, and develop a system to track prior authorizations needing additional follow up.
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We are looking for someone to manage insurance claims, appeals and denials. Job DescriptionJob DescriptionFull-Time Medical Biller/Front Desk Midwest Ear, Nose & Throat is looking for a full-time medical biller/front desk to join our staff.
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Kosher Food Option Available | Medical Insurance | Paid Holidays | Paid Vacation | Parental Leave | Sick Days. Serve as production manager for mail and electronic appeals, social media fundraising, newsletters, and donor correspondence.
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A 401k plan plus an employer match Comprehensive, medical, dental, vision, FSA, and prescription insurance from day one Competitive Paid Time Off with daily accrual from day one of employment, plus paid holidays Paid Parental Leave Adoption Assistance Firm paid life insurance Wellness programs Additional offerings include BDO Flex, Group Legal insurance, Pet insurance and Long-Term Care Insurance Above offerings may be subject to eligibility requirements.
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This individual is a subject matter expert on commercial pharmacy, major medical, and government insurance plans, prior authorizations, appeals, and alternate coverage referrals. Must have a thorough understanding and knowledge of commercial and government pharmacy and medical insurance programs, billing, alternate funding resources, reimbursement processes, prior authorization and appeal filings, and specialty pharmacy operations.
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medical insurance appeals jobs in Chicago, IL
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