Clinical Appeals Specialist

Job Summary:The Clinical Appeals Nurse is responsible for handling appeals requiringclinical input or interpretation**Responsibilities**:- Compose clinical appeal letters to send to payers for denial reconsiderations utilizing documentation, contract language, or voice recordings as applicable- Present a concise medical summary within each appeal based on...

Job DescriptionThe Appeals Specialist is responsible for performing end-to-end tasks for technical appeals. This involves triaging incoming inventory, validating appeal criteria, and composing technical denial arguments for reconsideration.The ideal candidate will have excellent communication skills, both written and verbal, and be able to work effectively...

Role SummaryWe are seeking a skilled Appeals Specialist to join our team in the Healthcare industry. As an Appeals Specialist, you will play a critical role in monitoring contractual allowances, analyzing and pursuing appeal opportunities with payers and networks, and reporting appeals performance.Key Accountabilities:Monitor contractual allowances and...

Job Summary:You will be working for a fast-growing business process outsourcing provider to provide support to one of our largest accounts and leading provider of healthcare services.This provider serves 959 hospitals and 2979 physician practices with over 50 million patient encounters annually.As an appeals non-clinical collector for one of the leading...

**About Auxis and the Role:**Auxis is seeking a skilled Clinical Appeals Specialist to join their team. As a key member of the organization, this individual will be responsible for handling appeals requiring clinical input or interpretation.Key Responsibilities:Compose appeal letters to payers using various sources of informationPresentation of clear and...

**Clinical Appeals Nurse Role at Auxis:**We are looking for a dedicated and detail-oriented Clinical Appeals Nurse to handle complex appeals requiring clinical input and interpretation. As a key member of our team, you will be responsible for composing compelling appeal letters and presenting concise medical summaries within each appeal.Main...

Bayer is changing the way we work to achieve higher productivity, faster innovation, and better results through our Dynamic Shared Ownership (DSO) approach.As a Clinical Operations Specialist, you will be responsible for executing study start-up activities in collaboration with local teams. This includes ensuring local translations are completed, compiling...

ResponsibilitiesTriage incoming inventory for the Appeals team, validating appeal criteria is metCompose technical denial arguments for reconsideration, including both written and telephonicallyIdentify contract protection that can be leveraged to overturn denials.Overcome objections that prevent payment of the claim and gain commitment for payment through...

Job Summary:You will be working for a fast-growing business process outsourcing provider to provide support to one of our largest accounts and leading provider of healthcare services.This provider serves 959 hospitals and 2979 physician practices with over 50 million patient encounters annually.As an appeals underpayment collector for one of the leading...

About AligntechAligntech is a global leader in the development of innovative technology, tools and treatment options to help dental professionals worldwide achieve clinical results.We believe that every smile is unique and we strive to create beautiful smiles through the integration of AI and machine learning, digital imaging and visualization, biomechanics...

Job Summary:The Healthcare Specialist will review post discharge, prebill accounts that do not have an authorization on file, ALOS versus days authorized variances, and/or other account discrepancies identified that will result in the account being denied by the payor that do not require a clinical review.Communicates with third party payors to resolve...

Key ResponsibilitiesThe Appeals Specialist will be responsible for the following key responsibilities:Triage incoming inventory and validate appeal criteria.Compose technical denial arguments for reconsideration.Identify contract protection that can be leveraged to overturn denials.Overcome objections that prevent payment of the claim and gain commitment for...

**Join a team that is changing millions of lives.**- Transforming smiles, changing lives_At Align Technology, we believe a great smile can transform a person's life, so we create technology that gives people the confidence to take on whatever's next.We revolutionized the orthodontic industry with the introduction of the Invisalign system, and we have never...

**Transforming Smiles and Changing Lives**At Align Technology, we are dedicated to creating technology that gives people the confidence to take on whatever's next.We revolutionized the orthodontic industry with the introduction of the Invisalign system, and we have never lost sight of that spirit of innovation.Our diverse and collaborative teams are...

Job Summary:You will be working for a fast-growing business process outsourcing provider to provide support to one of our largest accounts and leading provider of healthcare services.This provider serves 959 hospitals and 2979 physician practices with over 50 million patient encounters annually.As an appeals collector for one of the leading healthcare...

ResponsibilitiesProviding clear communication to stakeholders at key technical updatesLeading the design & execution of structured experimental plans to drive data-based decisionsUnderstanding the anatomy, clinical use cases, and user interface requirements to drive design decisionsKnowledge in design controls for design changesSupporting and successfully...

**Job Summary**You will be working for a leading business process outsourcing provider to support one of its largest accounts, a prominent healthcare services company. This organization serves 959 hospitals and 2979 physician practices with over 50 million patient encounters annually.The Senior Appeals Discrepancy Collector is responsible for researching and...

**Designing the Future of Orthodontic Treatments**At Align Technology, we believe that a great smile can transform a person's life, so we create technology that gives people the confidence to take on whatever's next.We are looking for a highly skilled CAD Designer to join our team in Belen and La Lima, CR office.This exciting new role would be part of a...

**Delivering Innovation in Digital Dentistry**At Align Technology, we are passionate about creating technology that gives people the confidence to take on whatever's next.We are seeking a highly skilled CAD Designer to join our team in Belen and La Lima, CR office.This exciting new role would be part of a culture that is helping to improve lives every day...

In this role, you'll be part of a global team transforming smiles and changing lives. As a Customer Service Agent, you'll play a vital role in helping dental professionals achieve the clinical results they expect.Your responsibilities will include:Adapting to our Customer Advocacy culture and responsibilitiesHandling all customer interactions with...