Expired Appeals Analyst jobs in Nashville, TN
Nashville, TN
$20,066-$81,124/year (est.)
Summary Research the substance of complex appeal or retrospective review requests including pre-pay and post-payment review appeal requests. Provide a thorough clinical review or benefit analysis to determine if the requested services meet medical necessity guidelines. Document decisions within...
Nashville, TN
$20,066-$81,124/year (est.)
Job Code: 10251-1574 Full-time No Weekends Job Summary The Clinical Appeals Analyst reports to the AVP, Payer Specialization and is responsible to support the Attorney serving in the role of Senior Counsel, Aetna Appeals. This individual will be responsible to confirm claim denials/appeals, place...
Nashville, TN
$20,066-$81,124/year (est.)
Summary Researches the substance of complex appeal or retrospective review requests including pre-pay and post-payment review appeal requests. Provides thorough clinical review or benefit analysis to determine if the requested services meet medical necessity guidelines. Documents decisions within...
Nashville, TN
$20,099-$81,259/year (est.)
***This is a work from home position*** Job Summary - Researches and Resolves High Dollar Technical and Top Dollar Clinical Appeals through concise understanding of Payer Contract Language and Clinical or Technical justification. Position requires individuals with high mathematical acumen, ability...
Nashville, TN
$20,066-$81,124/year (est.)
Do you want to join an organization that invests in you as a Clinical Appeals Analyst? At Parallon, you come first. HCA Healthcare has committed up to $300 million to our incredible team members over the course of three years. We are committed to providing our employees with the support they need....
Nashville, TN
$20,066-$81,124/year (est.)
Company : Highmark Wholecare Job Description : I. GENERAL OVERVIEW: The Appeals Analyst reviews inquiries to determine if they meet the definition of a grievance/appeal; documents, investigates, refers and coordinates grievances and appeals; initiates a case file for each grievance and appeal;...