Appeal Resolution Specialist jobs in the United States

Appeal Resolution Specialist logs, tracks, and processes appeals and grievances. Sets up and maintains case files for each grievance and collects the information required by organizational policies and applicable regulations. Being an Appeal Resolution Specialist conducts research and coordination needed to evaluate, process, respond to, and refer or close appeals. May require an associate degree or equivalent. Additionally, Appeal Resolution Specialist typically reports to a supervisor. The Appeal Resolution Specialist works under moderate supervision. Gaining or has attained full proficiency in a specific area of discipline. To be an Appeal Resolution Specialist typically requires 1-3 years of related experience, or may need 0 years of experience with additional specialized training and/or certification. (Copyright 2021

Grievance and Appeals Coordinator
  • TotalMed Professional
  • San Jose, CA
  • ... and appeal cases, assessing the priority of each case and routing to the appropriate staff ... resolution letters and communicating with members and providers within required timeframes
  • 1 hour ago

Community Support Specialist I - LEAP
  • Adams County Government
  • Westminster, CO
  • ... and the right to appeal. * Determines appropriate referrals to mandated work programs for ... Participates in dispute resolution process with applicant/participant when requested. * Prepares ...
  • 10 hours ago

Coding Specialist - Full Time - Medical Group Admin
  • Intermountain Healthcare
  • Salt Lake City, UT
  • ... resolution of complex professional claims issues requiring coding expertise. They provide ... Advanced coding knowledge (e.g., CCI edits, appeal management) Root cause analysis experience ...
  • yesterday

Patient Financial Services Denial Specialist, Full Time, Day Shift
  • Alameda Health System
  • Menlo Park, CA
  • The PFS Denial Specialist is responsible for validating dispute reasons following Explanation of ... appeal efforts for resolution. 5. Work payer projects as directed. 6. Research contract terms ...
  • 2 days ago

Supervisor Care Management/Clinical Appeals
  • Alameda Health System
  • San Mateo, CA
  • ... Care Management Specialist workflow for referral, post hospital appointments and utilization ... the appeal processes, until final resolution; coordinates and appeals clinical denials; develops ...
  • 2 days ago

Certification Specialist II
  • Seattle Housing Authority
  • Seattle, WA
  • Engage in dispute resolution with landlords, neighbors, and participants ... Document participant noncompliance or suspected fraud; prepare the SHA case in appeal hearings ...
  • 4 days ago

Revenue Cycle Specialist
  • Mind Springs Health
  • Grand Junction, CO
  • Responsible for billing, explanation of benefits, collection, denial resolution and posting ... The Western Slope of Colorado makes an appealing location for our staff members and their families
  • 5 days ago

*Part-Time* Resident Service Specialist - Ohana Military Communities (PMRF, Kauai)
  • Hunt Companies, Inc
  • Honolulu, HI
  • ... to resolution. * Assist in inspecting the model and vacant homes to ensure they are ready for ... All fees are rent are charged correctly in Yardi. * Assist with ensuring community curb appeal and ...
  • 5 days ago

Income Estimation for Appeal Resolution Specialist jobs
$43,468 to $53,855