Appeal Resolution Specialist jobs in New Jersey
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. (Copyright 2024 Salary.com)
Recently Added Appeal Resolution Specialist jobs
- HBSI
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Denville, NJ
FULL_TIME
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OverviewAccount Resolution SpecialistFacility Prime Healthcare Management Inc
Location US-NJ-Denville ID 2024-158827 Category Business Professional Position Type Full Time Shift Days Job Type Non-Exempt ResponsibilitiesPrime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 45 hospitals and has more than 300 outpatient locations in 14 states providing more than 2.6 million patient visits annually. It is one of the nation's leading health systems with nearly 50,000 employees and physicians. Fourteen of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team!
We are an Equal Opportunity Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation, or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf
QualificationsThe Specialist, Account Resolution is the lead responsible for the timely follow-up of Managed Care/Commercial accounts. Communicates clearly and efficiently by phone with health plans. Maintains productivity standards and reports. Responsible to obtain State collection guidelines if applicable. Reviews managed care contracts.
Connect With Us!EDUCATION, EXPERIENCE, TRAINING
1. Minimum of four years hospital managed care/commercial collector experience required.
2. Bachelor's degree or equivalent work experience preferred
3. Knowledge of contract interpretation
4. Familiar with hospital billing requirements
Not ready to apply? Connect with us for general consideration.
We believe that all persons are entitled to equal employment opportunity and does not discriminate against qualified employees or applicants because of race, color, national origin, ancestry, sex, marital status, child birth or related medical condition or any other protected category as defined by State or Federal Law. We are an equal opportunity employer and do not discriminate against applicants due to veterans status, disability, race, gender or other protected characteristics. - 3 Days Ago
- SanMar
-
Hightstown, NJ
FULL_TIME
- Join Our Family, Build Your Career! ABOUT US: SanMar Corporation has been family-owned since 1971. Based in Issaquah, WA, we are an award-winning, national supplier of 21 retail, private label and mil...
- 1 Day Ago
- Solar Specialist
-
Freehold, NJ
FULL_TIME,CONTRACTOR
- Job Overview: Solar Installer seeking a dynamic Outside Sales Manager to join our team in NJ/PA. The ideal candidate would build a team (or preferably bring one already in place) to canvass, set appoi...
- 2 Days Ago
- Resolution Counseling Center
-
Millburn, NJ
FULL_TIME
- $500 signing bonus! New hires will receive the signing bonus after working for 60 days.Want to join a collaborative team and work with clients you'll love?Full time, hybrid-work position: onsite 2 day...
- 24 Days Ago
- Medical Diagnostic Laboratories LLC
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Hamilton, NJ
FULL_TIME
- Medical Diagnostic Laboratories (MDL), member of the Genesis Biotechnology Group (GBG), is a CLIA certified clinical laboratory with multiple state licensing, specializing in state of the art, automat...
- 13 Days Ago
- GenesisClientCareerSite
-
Hamilton, NJ
FULL_TIME
- Specimen Resolution Assistant Job Summary: Medical Diagnostic Laboratories (MDL), a member of Genesis Biotechnology Group, is a CLIA certified clinical laboratory with multiple state licensing, specia...
- 13 Days Ago
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-
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-
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