appeals coordinator

Alignment Healthcare

<div>Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.
This position is remote in Orange, CA. 
 
The Appeals &amp; Grievance Coordinator is responsible for the day-to-day functions of the tracking and trending of all grievances, appeals, and complaints received within the Member Services Department. Acts as the primary investigator and contact person for member and provider grievances and appeals.
GENERAL DUTIES/RESPONSIBILITIES : 
1. Acknowledges the receipt of all grievance/appeals, and CTM (Complaint Tracking Module). 
2. Gathers pertinent and relevant information from the member and/or provider regarding the grievance/appeal, determines the appropriate resolution of the grievance/appeal per standard policies and procedures; and notifies the appropriate parties of the resolution and ensuring that all internal processes are completed to resolve the issue. 
3. Composes written correspondence to members in accordance to plan policy and CMS Guidelines. 
4. Conducts non-biased, accurate, timely and comprehensive investigation of all the facts related to the grievance/appeal. 
5. Thoroughly documents all action taken on behalf of the member or provider to resolve the grievance/appeal. 
6. Ensures that all grievances/appeals are processed in adherence to the Centers for Medicare and Medicaid (CMS) guidelines and plan policy. 
7. Prepares case files for Medical Director Review and external (including IRE) review of grievances/appeals as appropriate. 
8. Prepares clear, objective, accurate and comprehensive case histories for presentation and consideration at committee meetings (including Board of Directors). 
9. Maintains accurate and timely documentation, including complete files of all grievances/appeals. Prepares monthly and quarterly reports as requested. 
10. Identifies training opportunities and potential system and process improvements relating to grievance/appeal data. 
11. Participates in periodic review and update of grievance/appeal policies and procedures to reflect appropriate legal and CMS requirements as well as participate in periodic CMS Audit preparations and regulator meetings/interviews. 
12. Other duties as assigned.
Job Requirements:
Experience:<ul><li>Required: Two years&rsquo; experience in data entry and general office background.</li></ul>
Three years of customer service experience. Minimum 1 year Member Services or similar experience.<ul><li>Preferred: 2 years healthcare or insurance experience in a senior setting.</li></ul>
Education:<ul><li>Required: High School Diploma or GED.</li><li>Preferred: Associate degree (A.A.) degree.</li></ul>
Training:<ul><li>Required:</li><li>Preferred:</li></ul>
Specialized Skills:<ul><li>Required:</li></ul><ul><li>
Knowledge of MediCal and Medicare Managed Care Plans.</li><li>
Ability to Keyboard/Type 40+ words per minute and use the 10-key by touch.</li><li>
Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others.</li><li>
Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors;</li><li>
Language Skills: Ability to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of the organization.</li><li>
Mathematical Skills: Ability to add and subtract two-digit numbers and to multiply and divide with 10&rsquo;s and 100&rsquo;s. Ability to perform these operations using units of American money and weight measurement, volume, and distance.</li><li>
Reasoning Skills: Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions. Ability to deal with problems involving a few concrete variables in standardized situations.</li><li>
Problem-Solving Skills: Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment.</li><li>Preferred: Bi-lingual (English/Spanish)</li></ul>
Licensure:<ul><li>Required: None</li></ul>
Work Environment:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The noise level in the work environment is usually moderate.
Essential Physical Functions:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1 While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel and talk or hear.
2 The employee is frequently required to walk; stand; reach with hands and arms.
3 The employee is occasionally required to climb or balance and stoop, kneel, crouch, or crawl.
4 The employee must occasionally lift and/or move up to 20 pounds.
5 Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.
Pay Range: $44,790.00 - $67,185.00
Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.
Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.<ul><li>DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health&rsquo;s talent acquisition team, please email careers@ahcusa.com.</li></ul></div>

Appeals & Grievances Coordinator - Remote - Orange, CA

PacificSource Health Plans

<div><h1 class="jobSectionHeader">Looking for a way to make an impact and help people?</h1>
Join PacificSource and help our members access quality, affordable care!
PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person&rsquo;s talents and strengths.
Provide clerical assistance to Appeals and Grievance team in entry and maintenance of case records. Provide high quality customer service to internal and external customers regarding appeals and grievance inquiries. Support member and ensure customer satisfaction.
Essential Responsibilities:<ul><li>
Process intake of appeals and grievances into the departments tracking database.</li><li>
Monitor incoming documents via fax, web, email, USPS and route to appropriate entity in a timely manner and in accordance with department processes</li><li>
Maintain office supply inventory for the department.</li><li>
Communicate complex information related to A&amp;G rules and regulations, verbally and in writing, to internal and external customers.</li><li>
Effectively capture and transcribe meeting minutes.</li><li>
Work collaboratively in an objective, professional, diplomatic manner with all internal and external customers.</li></ul>
Supporting Responsibilities:<ul><li>
Provide clerical backup for other A&amp;G staff as needed.</li><li>
Meet department and company performance and attendance expectations.</li><li>
Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.</li><li>
Perform other duties as assigned.</li></ul>
Work Experience:
Minimum one year customer service, and/or claims processing, health insurance industry process experience required. Data entry experience preferred.
Education, Certificates, Licenses:
High School Diploma or equivalent required.
Knowledge:
Requires strong research, analytical and data entry skills. Experience using Facets, OnBase, and other software packages used by PacificSource is strongly preferred. Must have basic math skills, the ability to work under strict deadlines, and excellent organizational skills.
Competencies:
Adaptability
Building Customer Loyalty
Building Strategic Work Relationships
Building Trust
Continuous Improvement
Work Standards
Contributing to Team Success
Planning and Organizing
Environment:
Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time.
Skills:
Accountability, Collaboration, Communication (written/verbal), Flexibility, Listening (active), Organizational skills/Planning and Organization, Problem Solving, Teamwork
Compensation Disclaimer
The wage range provided reflects the full range for this position. The maximum amount listed represents the highest possible salary for the role and should not be interpreted as a typical starting wage. Actual compensation will be determined based on factors such as qualifications, experience, education, and internal equity. Please note that the stated range is for informational purposes only and does not constitute a guarantee of any specific salary within that range.
Base Range:
$32,311.65 - $51,698.64<h1 class="jobSectionHeader">
Our Values</h1>
We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business:<ul><li>
We are committed to doing the right thing.</li><li>
We are one team working toward a common goal.</li><li>
We are each responsible for customer service.</li><li>
We practice open communication at all levels of the company to foster individual, team and company growth.</li><li>
We actively participate in efforts to improve our many communities-internally and externally.</li><li>
We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community.</li><li>
We encourage creativity, innovation, and the pursuit of excellence.</li></ul>
Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.
Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.</div>

Appeals and Grievance Support (Monday-Friday)

Alight Solutions

<div>Do you have advanced experience in absence management leadership within appeals?
Amazing Opportunity and Great Place to Work!
Our story
At Alight, we believe a company&rsquo;s success starts with its people. At our core, we Champion People, help our colleagues Grow with Purpose and true to our name we encourage colleagues to &ldquo;Be Alight.&rdquo; We are passionate about connecting purpose with impact. Alight empowers clients to build a healthier and more financially secure workforce by unifying the benefits ecosystem across health, wealth, wellbeing, navigation, and absence management.
Our Benefits
With a comprehensive total rewards package, Alight offers programs and plans that support your mind, body, wallet, and life. Benefits include health, dental and vision coverages starting Day One. Additionally, Alight colleagues enjoy wellbeing programs, retirement plans with contribution matching, generous time off, parental leave, continuing education, and career growth opportunities &ndash; all within a thriving global organization.
Flexible Working
So that you can be your best at work and home, we consider flexible working arrangements wherever possible. Alight has been a leader in the flexible workspace and &ldquo;Top 100 Company for Remote Jobs&rdquo; 6 years in a row.
Great Place to Work
Thanks to the work of every colleague, Alight has received multiple awards of recognition including &ldquo;Great Place to Work&rdquo; for the past 7 years and Fortune&rsquo;s &ldquo;Best Companies to Work For.&rdquo; To learn more about our company culture and awards Click Here.
If you, Champion People, seek to Grow with Purpose, and embody the meaning of Be Alight &ndash; We invite you to join our team! Learn more at careers.alight.com.
Responsibilities<ul><li>
Leading LOA, STD, ADA, and/or LTD Appeals service teams.</li><li>
Developing strategy and business plans to deliver market-centric capabilities and processes.</li><li>
Working with broader organization and external parties to identify and gaps and develop a plan to address. Anticipating future trends and challenges, developing and implementing strategies to address opportunities.</li><li>
Assessing and evaluated business/technology partners to integrate products on various platforms. Developing and recommended Claims and Service level strategies and tactics.</li><li>
Demonstrating expertise in accurate Appeals Claim Management.
</li><li>Collaborating with peers and senior leadership to deliver exceptional service.</li><li>
Managing Appeals departmental budget and plan effectively for responsible growth.</li><li>
Enhancing the Claims team through regular business updates to ensure alignment with organizational goals. Fostering a culture of trust within the team.</li><li>
Establishing performance metrics with clear systems of measures and accountabilities that drive results.</li><li>
Ensuring that an effective system of regulatory compliance and internal controls have been maintained. Complying with applicable laws and regulations, and documented procedures that incorporated preventive and defective controls. Partnering with Regulatory Compliance and Risk Committees.</li></ul>
Requirements<ul><li>
Possess advanced education, equivalent work experience, training, or DMEC certification.</li><li>
Have experience of 10 years in claims/appeals and 7 years leadership in absence management.</li><li>
Display qualifications or experience in healthcare, rehabilitation, or a medical field.</li><li>
Hold Lean Six Sigma Certification and or formal Operations Strategy training.</li><li>
Have experience in leadership of a team of Managers within Appeals. This position oversees a total organization or roughly 40 professionals.</li></ul>
Application and Interview
By applying for a position with Alight, you understand that, should you be made an offer, it will be contingent on your undergoing and successfully completing a background check consistent with Alight&rsquo;s employment policies. Background checks may include some or all the following based on the nature of the position: SSN/SIN validation, education verification, employment verification, and criminal check, search against global sanctions and government watch lists, credit check, and/or drug test. You will be notified during the hiring process which checks are required by the position.
Alight requires all virtual interviews to be conducted on video.
Our commitment to Inclusion
We celebrate differences and believe in fostering an environment where everyone feels valued, respected, and supported. We know that diverse teams are stronger, more innovative, and more successful.
At Alight, we welcome and embrace all individuals, regardless of their background, and are dedicated to creating a culture that enables every employee to thrive. Join us in building a brighter, more inclusive future.
As part of this commitment, Alight will ensure that persons with disabilities are provided reasonable accommodations for the hiring process. If reasonable accommodation is needed, please contact alightcareers@alight.com.
Equal Opportunity Policy Statement
Alight is an Equal Employment Opportunity employer and does not discriminate against anyone based on sex, race, color, religion, creed, national origin, ancestry, age, physical or mental disability, medical condition, pregnancy, marital or domestic partner status, citizenship, military or veteran status, sexual orientation, gender, gender identity or expression, genetic information, or any other legally protected characteristics or conduct covered by federal, state, or local law. In addition, we take affirmative action to employ disabled persons, disabled veterans, and other covered veterans.
Alight provides reasonable accommodations to the known limitations of otherwise qualified employees and applicants for employment with disabilities and sincerely held religious beliefs, practices and observances, unless doing so would result in undue hardship. Applicants for employment may request reasonable accommodations/modifications by contacting their recruiter.
Authorization to work in the Employing Country
Applicants for employment in the country in which they are applying (Employing Country) must have work authorization that does not, now or in the future, require sponsorship of a visa for employment authorization in the Employing Country and with Alight.
Note, this job description does not restrict management's right to assign or reassign duties and responsibilities of this job to other entities; including but not limited to subsidiaries, partners, or purchasers of Alight business units.
We offer you a competitive total rewards package, continuing education &amp; training, and tremendous potential with a growing worldwide organization.
Salary Pay Range
Minimum :
110,000.00 USD
Maximum :
130,000.00 USD
Pay Transparency Statement: Alight considers a variety of factors in determining whether to extend an offer of employment and in setting the appropriate compensation level, including, but not limited to, a candidate&rsquo;s experience, education, certification/credentials, market data, internal equity, and geography. Alight makes these decisions on an individualized, non-discriminatory basis. Bonus and/or incentive eligibility are determined by role and level. Alight also offers a comprehensive benefits package; for specific details on our benefits package, please visit: Wellbeing and Benefits Selector Page - Alight 
DISCLAIMER: 
Nothing in this job description restricts management's right to assign or reassign duties and responsibilities of this job to other entities; including but not limited to subsidiaries, partners, or purchasers of Alight business units.
Alight Solutions provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, creed, sex, sexual orientation, gender identity, national origin, age, disability, genetic information, pregnancy, childbirth or related medical condition, veteran, marital, parental, citizenship, or domestic partner status, or any other status protected by applicable national, federal, state or local law. Alight Solutions is committed to a diverse workforce and is an affirmative action employer.</div>

Claims Operations Director- Appeals-Alight Leave Solutions

PHI Air Medical

<div>Join Our Life-Saving Team in Phoenix, AZ today and take advantage of a $7,500 sign on bonus &mdash; this offer won&rsquo;t last long! Apply Today!
Are you ready to elevate your career to new heights? PHI Health is looking for dynamic, driven individuals to join our team. We are committed to providing top-tier emergency medical services with unmatched speed and efficiency, saving lives when every second counts. By supporting our mission from the ground, you will play a crucial role in orchestrating the seamless operations that keep our advanced fleet soaring and our patients safe.
With PHI Health you&rsquo;ll collaborate with the best minds in the industry, driving initiatives that enhance our services and expand our reach to those who need it most. If you're passionate about making a difference and thrive on challenges, PHI Health offers an extraordinary opportunity to impact lives and develop your professional career in a meaningful way.
Who We Are:
PHI Health is the leading air ambulance provider in the United States. With an unmatched safety record and the best aviation, medical and communication specialists in the field, we set the standard in the air medical industry. We transport more than 22,000 patients each year from our more than 80 bases across the country, all while offering services and outreach education to local communities and leading healthcare systems. Our mission is simple: move communities to health while maintaining the highest standard of safety, period.
Job Summary:
The appeals negotiator is responsible for ensuring the highest reimbursement for all underpaid contractual and non-contractual payers. The negotiator will build and maintain outstanding relationships with all payers while adhering to PHI reimbursement policies. The negotiator will identify, document, and assist in the collections of all contracted and non-contracted underpayments from the payers. The negotiator will provide and produce thorough supporting documentation regarding additional payment for the level of services that were rendered. This position provides oversight and resolution for claim denials that require written response. This includes denials for medical necessity, low &quot;usual and customary&quot; payments, not to the closest facility, and reduction to ground level payments. This position requires a high level of knowledge in compliance, federal and state regulations, and clinical record information extraction. This position reports to the leadership of Patient Financial Services.
Compensation and Benefits<ul><li>
We offer a range of competitive pay and benefits package to keep our teams happy, healthy, and invested.</li></ul>
Schedule/Location<ul><li>
5 &amp; 2</li><li>
Phoenix, AZ</li></ul>
The Successful Candidate Will Have:<ul><li>
High School diploma or GED required.</li><li>
Bachelor's degree preferred with 5 years related work experience.</li><li>
5+ years' experience in medical billing, surgical billing, billing in emergency medical services and collections preferred.</li><li>
Medicare, Managed Care, Workers' Comp. experience.</li><li>
3-5 years of experience in appeals and negotiation background.</li><li>
Expertise in billing software and Internet-based research required.</li><li>
Must have solid knowledge of patient account systems, revenue management processes, workflow systems and the ability to troubleshoot and suggest improvements.</li><li>
Ability to work independently with strong interpersonal skills to effectively interact with all levels of employees both with the client and with PFS.</li><li>
Must have demonstrated experience in researching statutes and understanding regulatory documents.</li><li>
Must demonstrate the ability to draft a professional and effective appeal letter.</li><li>
Ability to verbally communicate details and understand parameters of job responsibilities.</li><li>
Ability to provide written communication using best business practices when composing letters, memorandums, and e-mails regardless of if the communication is inside the Company or with customers, clients, or providers.</li><li>
Ability to read, write and follow specific instructions in both written and verbal form.</li><li>
Requires an in-depth understanding of compliance, regulatory oversight bodies and payer requirements.</li><li>
Team player, interfaces well with employees.</li><li>
Represents the company in a positive, customer friendly attitude to other employees, clients, agencies, entities and patients.</li><li>
May have supervisory responsibility.</li><li>
This position is designated Safety Sensitive for purposes of the Arizona Medical Marijuana Act.</li></ul>
Our Core Competencies:<ul><li>
Safe. We are absolute in our belief in the tenets of Destination Zero and that Zero is not only achievable, but the only acceptable outcome.</li><li>
Efficient. We are focused on outcomes that are smart and responsible by making the best use of our resources to maximize overall productivity and achieve sustainable profitability as a high performing organization.</li><li>
Quality. We are committed to ensuring excellent organizational performance which produces sustainable and reliable outcomes.</li><li>
Service. We are dedicated to the service of our customers, our communities and each other.</li></ul>
The PHI Health Advantage
For more than 40 years, our company has been providing critical air medical transport services across the country. As an organization, we outfit each aircraft we fly with the most advanced technology, subject our crews to the most rigorous protocols and training and pioneer the most-forward thinking safety program in the country.
Everything that we do comes back to the safety of our crew and our patients. Our accident rate is well below the national average and we were the first to receive the Vision Zero Aviation Safety Award. This belief has guided us towards a number of industry firsts and has given us the highest safety rating in the industry.
Join Our Life-Saving Team in Phoenix, AZ today and take advantage of a $7,500 sign on bonus
DISCLAIMER
The above Statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed, as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.
PHI, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws</div>

Appeals Negotiator - NSA

Texas Department Of Criminal Justice

<div>
 <ul>
 <li>
 PDate 043026 033233 Location of vacancy: Estelle Unit/Huntsville
 </li>
 <li>
 This website contains only partial information regarding this job posting and application procedures.
 </li>
 <li>
 For complete information regarding minimum qualification requirements, availability of study material, work site visits and TDCJ application instructions, go to www.tdcj.texas.gov. Click on EMPLOYMENT and JOB SEARCH. When applying for this position, please reference TDCJ Job Posting No. 019099E2.
 </li>
 </ul>
</div>

INVESTIGATOR I - Inmate Grievance

Provox Global Solutions

We are hiring an experienced Dental Billing Coordinator to support a multi-location dental group based in Texas. Our client operates approximately 20 offices on Dentrix Enterprise transitioning to Curve. The successful candidates will be embedded with the client&rsquo;s billing function and will report directly to the client&rsquo;s Billing Manager.This is not a back-office data entry role. The Billing Coordinator is accountable for the full revenue cycle &mdash; from claim creation through submission, posting, denials, appeals, and AR follow-up. The work is methodical, detail-driven, and measured against clear performance KPIs. Candidates who have been held to numerical targets in past roles and can speak fluently to those numbers will stand out.What You Will Do<ul><li>Own end-to-end billing for assigned offices and providers, from claim creation through final adjudication and payment posting.</li><li>Bill out all claims within 48 hours of date of service</li><li>Submit clean claims through the clearinghouse, including correct CDT coding, appropriate narratives, and required attachments (x-rays, perio charts, intraoral images).</li><li>Post insurance payments accurately, including ERA reconciliation, contractual write-offs, adjustments, and triggering of secondary claims.</li><li>Work the AR aging report on a strict cadence &mdash; no claim over 30 days untouched, with priority focus on the 60+ and 90+ day buckets.</li><li>Manage denials and rejections methodically: investigate the root cause, correct the underlying issue, and submit timely appeals with supporting documentation.</li><li>Communicate professionally and promptly with office staff and providers when missing information, coding clarifications, or clinical narratives are needed.</li><li>Track and report individual performance against committed KPIs (clean claim rate, days in AR, percentage of AR over 90 days, net collection ratio, write-off accuracy).</li><li>Identify recurring issues &mdash; payer-specific quirks, coding errors, documentation gaps &mdash; and escalate them with proposed solutions.</li><li>Maintain compliance with HIPAA and all relevant patient data handling protocols.</li></ul>Required Qualifications<ul><li>Minimum 3 years of hands-on US dental billing experience, including end-to-end ownership of the revenue cycle (not just one slice such as posting or verification).</li><li>Strong working knowledge of dental Medicaid billing &mdash; eligibility rules, prior authorization requirements, fee schedules, and common denial patterns.</li><li>Working knowledge of Medicare Advantage dental benefits and the differences between Advantage plans and traditional commercial PPOs.</li><li>Demonstrated ability to talk specifically about past performance through KPIs &mdash; collection percentage, write-off percentage, days in AR, clean claim rate, denial rate. Candidates who cannot speak to numbers from prior roles will not be considered.</li><li>Proficiency with at least one major dental practice management system (Dentrix, Dentrix Enterprise, Eaglesoft, Open Dental, or Denticon).</li><li>Comfortable working within a major dental clearinghouse (Claim.MD, DentalXChange, Vyne Trellis, or equivalent).</li><li>Strong written and verbal English communication skills &mdash; this role interacts directly with US-based providers, office managers, and the client's billing manager on a daily basis.</li><li>Ability and willingness to work the 6:00 PM to 3:00 AM PKT shift to align with US Central Time business hours.</li><li>High attention to detail, methodical work habits, and disciplined follow-up &mdash; these are the three qualities that separate strong billers from average ones.</li></ul>Job Type: Full-timeApplication Question(s):<ul><li>This is an onsite-based position, and the shift timings are from 6:00 PM to 3:00 AM PKT to align with US Central Time business hours. Are you comfortable with this?</li></ul>Experience:<ul><li>Dentrix : 1 year (Required)</li><li>Dental Billing : 1 year (Required)</li><li>AR: 1 year (Required)</li></ul>Work Location: In person

Dental Billing Specialist

TidalHealth

<div></div><ul><div><div>Location</div>
 Salisbury, MD
</div><div></div><div><div>Facility</div>
 TidalHealth Primary &amp; Specialty Care
</div><div></div><div><div>Department</div>
 Medical Oncology - Salisbury
</div><div></div><div><div>Schedule - Shift - Hours</div>
 Full Time - Monday - Friday - 8:00 am to 4:30 pm
</div><div>Req #: 36280</div></ul>
 <div><div>Why work at TidalHealth?
Looking for a rewarding place to work? Choose TidalHealth. Our hospitals have been named among the Top 5 percent of all U.S. hospitals by Healthgrades and a five-star hospital by the Centers for Medicare &amp; Medicaid Services. Located just 30 minutes from the beach, TidalHealth offers the widest array of specialty and subspecialty services such as neurosurgery, cardiothoracic surgery, joint replacement, emergency/trauma care, comprehensive cancer care, wound care and clinical trials and research. Take advantage of our tuition and certification assistance programs to grow both personally and professionally.
Patient Accounts Coordinator Position Summary
The inventory, distribution/delivery of medications is required for all Patient Care area Positions.
The Patient Account Coordinator is responsible for coordinating the insurance verification, pre-certification, billing, and follow-up process and workflow for the Richard A. Henson Cancer Institute and/or the Allen Cancer Center. Coordinates third-party payers&rsquo; requirements related to access, registration, billing and collection of accounts. Ensures all verifications and information is completed in accordance with established regulatory and policy requirements. Facilitates workflow between TidalHealth&rsquo;s finance departments, the Richard A. Henson Cancer Institute departments, and/or Allen Cancer Center departments (radiation oncology, medical oncology, infusion center, oncology lab). Is responsible for identifying and enrolling patients in patient assistance programs and/or drug replacement programs for oral and IV chemotherapy/biotherapy regimens. Maintains compliance with all applicable regulations
Patient Accounts Coordinator Position Requirements
Education
<ul><li>High School graduate or equivalent required.
</li></ul>Experience
<ul><li>One (1) year business office experience is required
</li><li>Knowledgeable with Microsoft Office computer programs, spreadsheets and general office work preferred.
</li><li>Experience in a finance related field, including medical billing, preauthorizations, denials, and appeals preferred.
</li><li>Previous experience within registration is preferred.
</li><li>Customer service experience preferred. Requires six months on-the-job training.
</li><li>Epic EMR experiene is preferred
</li></ul>Patient Accounts Coordinator Work Schedule
<ul><li>Day shift, Monday through Friday, with overtime and possible weekends as required.</li>
<li>Rotating day, evening, night shift, week and weekend, with overtime as required.</li>
<li>Expected to work overtime and other shifts as required by staffing needs.</li>
</ul>
Patient Accounts Coordinator Benefits
<ul><li>At TidalHealth, full-time employees working at least 72 hours per pay period, part-time employees working at least 36 hours per pay period and part-time employees working at least 30 hours or more on weekends only are eligible for benefits.
</li><li>Benefits include medical, prescription, vision, dental, flexible spending accounts, disability insurance plans, life insurance, paid time off plans, retirement plans, tuition assistance, employee assistance, and access to on-site childcare and a credit union.</li></ul></div></div>

Coordinator - Patient Accounts

Search 3560+ Appeals coordinator jobs near you this May. New roles added regularly across leading industries. Apply today.