Top 88 Linux skills specialist Jobs in Denmark

Appeals Resolution Specialist
National Seating & Mobility, Inc. —North, SC
- Remote
- Pass drug screening
- Research
- Mid-level
- Disability insurance
- 401(k)
Quick Apply
5d
Mental Health Professional I - School Based / Bamberg County Schools
State of South Carolina —Orangeburg County, SC
- $51,039 - $77,000 a year
- Full-time
- School experience
- Spanish
- English
- Paid parental leave
- Paid holidays
Mental Health Professional I - School Based / Holly Hill
State of South Carolina —Orangeburg County, SC
- $51,039 - $77,000 a year
- Full-time
- School experience
- Spanish
- English
- Paid parental leave
- Paid holidays
Stop-Out Prevention Specialist
CLAFLIN UNIVERSITY —Orangeburg, SC
- Full-time
- Research
- Mid-level
- University
Quick Apply
Mental Health Professional I - Addictions Counselor - ACT Program (Orangeburg)
State of South Carolina —Orangeburg County, SC
- $51,039 - $59,664 a year
- Full-time
- Spanish
- Addiction Medicine
- English
- Paid parental leave
- Paid holidays
Information Technology Specialist III
CLAFLIN UNIVERSITY —Orangeburg, SC
- Weekends as needed
- Computer science
- Computer Science
- System design
Quick Apply
Library Specialist
Denmark Technical College —Bamberg County, SC
- $44,000 a year
- Full-time
- Word processing
- Computer literacy
- Writing skills
- Disability insurance
- Health insurance
Instructor/Senior Media Specialist (Production)
CLAFLIN UNIVERSITY —Orangeburg, SC
- Weekends as needed
- Mid-level
- Windows
- 3 years
Quick Apply
Mental Health Professional I / Barnwell (Barnwell)
State of South Carolina —Barnwell County, SC
- $51,039 - $72,000 a year
- Full-time
- Spanish
- Adults
- English
- Paid parental leave
- Paid holidays
Academic Registraion and Transfer Specialist Job Description
CLAFLIN UNIVERSITY —Orangeburg, SC
- Weekends as needed
- Computer literacy
- Writing skills
- English
Quick Apply
Electrical Controls Specialist
Bimbo Bakeries USA —Orangeburg, SC
- $74,900 - $97,400 a year
- Basic math
- English
- Mid-level
- Tuition reimbursement
- Paid time off
Warranty Specialist & Technical Support
Atlas Carts - The most advanced personal cart EVER imagined. —Williston, SC
- Full-time
- Mid-level
- Office
- Ability to lift 50 pounds
Quick Apply
Training and Support Specialist - North Carlonia
Software Technology Inc —North, SC
- Mid-level
- Classroom experience
- Communication skills
Quick Apply
Building and Grounds Specialist
Denmark Technical College —Bamberg County, SC
- $16.50 - $19.00 an hour
- Temporary
- Inventory management
- Office
- High school diploma or GED
- Disability insurance
- Health insurance
Retail Service Specialist
O'Reilly Automotive Stores —Barnwell, SC
- Full-time
- ASE Certification
- Merchandising
- Mid-level
- Employee stock purchase plan
- Health insurance
Quick Apply
Military Service - U.S. Navy, Information Technology Professional
U.S. Navy —United States
- $67,000 - $85,000 a year
- Full-time
- Background check
- High school diploma or GED
- Bachelor's degree
- Loan repayment program
- Health insurance
9d
Airtable Implementation Specialist
Rudd Consulting —United States
- $50 - $60 an hour
- Part-time
- Remote
- Background check
- Mid-level
- JavaScript
Quick Apply
Clinical Documentation Specialist (Remote Part-Time Contract)
OnPoint Healthcare Solutions —United States
- $52 - $60 an hour
- Full-time
- Remote
- RN License
- 5 years
- Senior level
- Health insurance
- Dental insurance
Quick Apply
1d
Licensed Insurance Professional
Prestige Partners —United States
- $45,000 - $80,000 a year
- Part-time
- Remote
- Background check
- Communication skills
- Entry level
- Work from home
- Flexible schedule
Quick Apply
1d
Precast Refractory Technical Specialist
RHI Magnesita —United States
- Remote
- 5 years
- Analysis skills
- Bachelor's degree
- Mileage reimbursement
- Disability insurance
Quick Apply
12d

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Appeals Resolution Specialist

National Seating & Mobility, Inc. -
North, SC

Quick Apply

Job Details

5 days ago

Benefits

Disability insurance
401(k)
Tuition reimbursement

Qualifications

Optimizing workflow processes
Appeals
Caseload management
Research
Incident Escalation
High school diploma or GED
Case appeal in utilization management
Continuous improvement
Health insurance pre-authorization requirements
Productivity software
Root cause analysis
Insurance claims appeal handling
Escalation handling

Full Job Description

The Appeal Resolution Specialist is responsible for managing complex payer deferrals, denials, and appeals to support timely resolution and successful authorization outcomes. This role serves as a subject matter expert in researching payer decisions, identifying root causes, determining appropriate resolution strategies, and preparing accurate and comprehensive appeal submissions.

The Appeal Resolution Specialist collaborates with internal teams, payers, and other stakeholders to resolve funding barriers while ensuring compliance with payer requirements, organizational policies, and applicable regulatory guidelines. The position requires strong analytical skills, attention to detail, effective written and verbal communication, and the ability to independently manage complex cases through resolution.

Company Description:

At all levels, working at National Seating & Mobility provides the opportunity to directly impact our clients’ lives by giving them self-reliance and independence. Our teams are comprised of passionate individuals, dedicated to providing the best care to each client. We focus on abilities by leveraging technology and creating mobility solutions that are as unique as our client’s needs.

Working at National Seating & Mobility is an opportunity to build a meaningful career, while leaving a lasting impact on the lives of those we serve. Located in more than 40 states, we strive for diversity and offer an array of benefits including 401k, company paid Long Term Disability, and tuition reimbursement.

Duties and Responsibilities / Essential Functions:

Review and manage assigned deferrals, denials, and appeals to determine the appropriate course of action and ensure timely resolution.

Analyze payer correspondence, denial reasons, authorization requirements, medical documentation, and account history to identify the underlying cause of the payer decision.

Research payer policies, coverage criteria, contractual requirements, and applicable guidelines to determine appeal opportunities and resolution strategies.

Prepare clear, accurate, and persuasive appeal submissions supported by appropriate documentation and payer requirements.

Coordinate with internal departments to obtain missing or additional documentation necessary to support an appeal or resolve a deferral.

Communicate directly with payers, healthcare providers, and internal stakeholders to clarify requirements, address outstanding issues, and facilitate resolution.

Monitor appeal deadlines and payer response timeframes to ensure cases are worked within established requirements.

Perform appropriate follow-up throughout the appeal process and escalate complex or high-risk cases when necessary.

Maintain complete and accurate documentation of appeal activity, payer communication, decisions, and resolution outcomes within applicable systems.

Identify recurring denial and deferral trends and communicate findings to leadership to support process improvement initiatives.

Partner with operational, funding, billing, training, and quality teams to identify opportunities to reduce preventable denials and improve first-pass success.

Serve as a resource and subject matter expert regarding payer appeal processes, documentation requirements, and resolution strategies.

Maintain current knowledge of payer policies, regulatory requirements, and organizational procedures affecting authorization and appeals.

Meet established productivity, quality, timeliness, and resolution performance expectations.

Support special projects, audits, process improvements, and other departmental initiatives as assigned.

Work Environment:

This job operates in a professional office environment. This role routinely involves standard office equipment such as computers, phones, printers, photocopiers, filing cabinets and fax machines.

Physical Demands:

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. While performing the duties of this job, the employee is regularly required to talk or hear. The employee is regularly required to sit; use hands repetitively to operate standard office equipment. The employee is frequently required to reach with hands and arms.

Required Education, Experience & Competencies:

High School Diploma or G.E.D. Required

Drug Test

Strong knowledge of healthcare payer requirements, authorization processes, denials, deferrals, and appeals.

Ability to interpret payer policies, medical documentation, correspondence, and coverage requirements.

Strong analytical and problem-solving skills with the ability to identify root causes and determine appropriate resolution strategies.

Excellent written communication skills with the ability to develop concise, well-supported appeal documentation.

Strong verbal communication and interpersonal skills when working with payers and internal and external stakeholders.

Excellent organizational and time-management skills with the ability to manage multiple cases and deadlines simultaneously.

High level of accuracy and attention to detail.

Ability to work independently, exercise sound judgment, and appropriately escalate complex issues.

Ability to identify trends and recommend opportunities for process improvement.

Proficiency with applicable payer portals, Microsoft Office applications, and other business technology.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.

Quick Apply

Refine Your Search

linux skills specialist jobs in denmark

Appeals Resolution Specialist

Mental Health Professional I - School Based / Bamberg County Schools

Mental Health Professional I - School Based / Holly Hill

Stop-Out Prevention Specialist

Mental Health Professional I - Addictions Counselor - ACT Program (Orangeburg)

Information Technology Specialist III

Library Specialist

Instructor/Senior Media Specialist (Production)

Mental Health Professional I / Barnwell (Barnwell)

Academic Registraion and Transfer Specialist Job Description

Electrical Controls Specialist

Warranty Specialist & Technical Support

Training and Support Specialist - North Carlonia

Building and Grounds Specialist

Retail Service Specialist

Military Service - U.S. Navy, Information Technology Professional

Airtable Implementation Specialist

Clinical Documentation Specialist (Remote Part-Time Contract)

Licensed Insurance Professional

Precast Refractory Technical Specialist

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