Talent.com
Appeals Specialist

Appeals Specialist

VirtualVocationsOxnard, California, United States
30+ days ago
Job type
  • Full-time
Job description

A company is looking for an Appeals Specialist to perform non-medical reviews and process redetermination letters.

Key Responsibilities

Perform non-medical reviews and process redetermination letters ensuring timeliness and accuracy

Prepare unit reports, analyze and interpret workload, and process issues utilizing various software tools

Update letters and documents with the department when necessary and gather documentation for legal inquiries

Required Qualifications

High School Diploma or equivalent

2 years of experience in a job-related field

Proficiency in Microsoft Office

Experience in reviewing medical documentation is preferred

Create a job alert for this search

Specialist • Oxnard, California, United States

Related jobs
  • Promoted
Appeals Management Coordinator

Appeals Management Coordinator

VirtualVocationsSan Buenaventura, California, United States
Full-time
A company is looking for a Coordinator, Appeals Management.Key Responsibilities Perform denial research and follow-up with insurance companies to resolve outstanding appeals Compile and submit a...Show moreLast updated: 30+ days ago
  • Promoted
  • New!
Senior Coordinator, Appeals Management

Senior Coordinator, Appeals Management

VirtualVocationsOxnard, California, United States
Full-time
A company is looking for a Senior Coordinator, Complaint and Appeals (Remote, PST).Key Responsibilities Oversee investigations and resolutions of appeals, ensuring timely and customer-focused res...Show moreLast updated: 10 hours ago
  • Promoted
Local Family Driver - Apply Today for Flexible Work

Local Family Driver - Apply Today for Flexible Work

Copilot CareersFrazier Park, CA, United States
Full-time
Make a difference in your community while earning up to $50 per ride with HopSkipDrive’s $500 Welcome Guarantee! Terms apply. We partnered with HopSkipDrive to find responsible CareDrivers to provid...Show moreLast updated: 1 day ago
  • Promoted
Healthcare Insurance Specialist

Healthcare Insurance Specialist

VirtualVocationsSan Buenaventura, California, United States
Full-time
A company is looking for a Healthcare Insurance and Benefits Specialist.Key Responsibilities Perform outbound calls and assist patients with inbound calls Review and process prior authorization ...Show moreLast updated: 13 days ago
  • Promoted
  • New!
Tennessee Licensed Appeals Coordinator

Tennessee Licensed Appeals Coordinator

VirtualVocationsSan Buenaventura, California, United States
Full-time
A company is looking for an Appeals and Letters Coordinator remote position.Key Responsibilities : Process denial-related and member-oriented written communications in compliance with Federal and ...Show moreLast updated: 14 hours ago
  • Promoted
A / R Follow Up Specialist

A / R Follow Up Specialist

VirtualVocationsSan Buenaventura, California, United States
Full-time
A company is looking for an AR Follow Up Specialist to manage unresolved insurance claims and ensure timely payments.Key Responsibilities Follow up on unresolved claims and check claim status wit...Show moreLast updated: 30+ days ago
  • Promoted
Denials Specialist

Denials Specialist

VirtualVocationsSan Buenaventura, California, United States
Full-time
A company is looking for a Denials Specialist - REMOTE.Key Responsibilities Validate denial reasons and ensure accurate coding in the DCM system Generate appeals based on dispute reasons and pay...Show moreLast updated: 30+ days ago
  • Promoted
Complaint and Appeals Coordinator

Complaint and Appeals Coordinator

VirtualVocationsSan Buenaventura, California, United States
Full-time
A company is looking for a Coordinator, Complaint & Appeals (Remote).Key Responsibilities Reviews and processes appeals and grievances filed by patients Conducts internal audits and addresses co...Show moreLast updated: 30+ days ago
  • Promoted
Payment Accuracy Specialist

Payment Accuracy Specialist

VirtualVocationsOxnard, California, United States
Full-time
A company is looking for a Payment Accuracy Specialist 1.Key Responsibilities Audit client data and generate recoverable claims while documenting findings Utilize audit tools and systems to revi...Show moreLast updated: 30+ days ago
  • Promoted
  • New!
Insurance Appeals Specialist

Insurance Appeals Specialist

VirtualVocationsSan Buenaventura, California, United States
Full-time
A company is looking for an Insurance Appeals Specialist to manage and draft responses to deductions taken by insurance companies on defense counsel invoices. Key Responsibilities Manage the revie...Show moreLast updated: 10 hours ago
  • Promoted
Managed Care Appeals Analyst

Managed Care Appeals Analyst

VirtualVocationsSan Buenaventura, California, United States
Full-time
A company is looking for a Managed Care Appeals Analyst.Key Responsibilities Research and review $0 balance accounts for contractual reimbursements and post necessary adjustments Create detailed...Show moreLast updated: 3 days ago
  • Promoted
Title & Escrow Application Specialist

Title & Escrow Application Specialist

VirtualVocationsSan Buenaventura, California, United States
Full-time
A company is looking for a Title & Escrow Application Specialist with SoftPro Select experience.Key Responsibilities Provide hands-on product support, troubleshoot user issues, and document solut...Show moreLast updated: 1 day ago
  • Promoted
  • New!
Grievance & Appeals Coordinator

Grievance & Appeals Coordinator

VirtualVocationsOxnard, California, United States
Full-time
A company is looking for a Grievance & Appeals Coordinator I.Key Responsibilities Analyze and resolve claims and authorization appeals from providers and formal grievances from members Prepare r...Show moreLast updated: 8 hours ago
  • Promoted
Remote Commercial Banking Analyst - AI Trainer

Remote Commercial Banking Analyst - AI Trainer

Data AnnotationCamarillo, California
Remote
Full-time +1
We are looking for a finance professional to join our team to train AI models.You will measure the progress of these AI chatbots, evaluate their logic, and solve problems to improve the q...Show moreLast updated: 29 days ago
  • Promoted
Texas Licensed Clinical Appeals Coordinator

Texas Licensed Clinical Appeals Coordinator

VirtualVocationsOxnard, California, United States
Full-time
A company is looking for a Clinical Appeals Coordinator.Key Responsibilities Act as the liaison for statewide appeals, ensuring compliance with State and NCQA requirements Review clinical inform...Show moreLast updated: 1 day ago
  • Promoted
  • New!
Inquiry Resolution Specialist

Inquiry Resolution Specialist

VirtualVocationsSan Buenaventura, California, United States
Full-time
A company is looking for an Inquiry Resolution Representative to research and resolve patient disputes while ensuring compliance with relevant laws and regulations. Key Responsibilities Investigat...Show moreLast updated: 12 hours ago
  • Promoted
New York Licensed Clinical Appeals Specialist

New York Licensed Clinical Appeals Specialist

VirtualVocationsSan Buenaventura, California, United States
Full-time
A company is looking for a Clinical Denials & Appeals Specialist (Remote).Key Responsibilities Review and respond to Corporate Compliance Audits and denial trends Prepare and defend level of car...Show moreLast updated: 30+ days ago
  • Promoted
Local Family Driver - Flexible Hours - Apply Now

Local Family Driver - Flexible Hours - Apply Now

Copilot CareersFrazier Park, CA, United States
Full-time
Make a difference in your community while earning up to $50 per ride with HopSkipDrive’s $500 Welcome Guarantee! Terms apply. We partnered with HopSkipDrive to find responsible CareDrivers to provid...Show moreLast updated: 1 day ago