Top 21 Appeals Jobs in Lexington Park, Md

APPEALS COORDINATOR
Calvert Health System —Prince Frederick, MD
- $35 - $50 an hour
- Part-time
- Nursing
- RN License
- Computer literacy
Quick Apply
Asst Living Act Asst Non-Lic
PruittHealth —Charlotte Hall, MD
- $18.89 - $28.33 an hour
- Full-time
- Background check
- Nursing home
- Mid-level
Food Service Worker - Chesapeake Shores Nursing Center - Food
Aramark —Lexington Park, MD
- $15 an hour
- Fair chance
- Cash handling
- Entry level
- Disability insurance
- Health insurance
Activities Asst Non-Lic
PruittHealth —Charlotte Hall, MD
- $18.06 - $27.10 an hour
- Part-time
- Background check
- Nursing home
- Mid-level
Physical Therapy Front Desk Coordinator
The Centers for Advanced Orthopedics —Prince Frederick, MD
- $19 an hour
- CPR Certification
- BLS Certification
- English
Quick Apply
Early Childhood Teacher - PAC
Calvert County Public School District —Lusby, MD
- $55,085 - $148,800 a year
- Full-time
- Classroom
- Teaching Certification
- Pass drug screening
- Flexible schedule
Asst Living Act Asst Licensed
PruittHealth —Charlotte Hall, MD
- $18.06 - $27.10 an hour
- Full-time
- Background check
- Nursing home
- Mid-level
Pizza Line Cook
Ledo Pizza —Prince Frederick, MD
- $13.25 - $16.00 an hour
- Part-time
- Ability to lift 50 pounds
- Organizational skills
- In-person
- Employee discount
- Flexible schedule
Quick Apply
2d
Director of Development
Historic St. Mary’s City —St. Mary's City, MD
- $85,000 - $120,000 a year
- Part-time
- Office
- Bachelor's degree
- Senior level
- Paid holidays
- Health insurance
11d
Maintenance Manager
Kettler Enterprises, Inc —Naval Air Station Patuxent River, MD
- $36.05 an hour
- Overtime
- Customer service
- Computer literacy
- English
- Health savings account
- Health insurance
Host/Hostess
Applebee's —Prince Frederick, MD
- Part-time
- Bilingual
- Bar
- Casual dining restaurant
Quick Apply
Fractional Healthcare & Regulatory Counsel
bVital Park City —United States
- Full-time
- Remote
- HIPAA
- Senior level
- Flexible schedule
Quick Apply

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Referral Coordinator
Calvert Internal Medicine Group —Prince Frederick, MD
Train new staff in referral entry as needed. Support providers by handling patient messages, requests, and documentation. Prince Frederick, MD 20678 (Required).
$17 - $20 an hour
Quick Apply
Utilization Review Case Manager - Partial Hospitalization Program
Luminis Health —Annapolis, MD
Verifies prior authorization data and performs concurrent reviews with external review agents on a daily basis in order to provide medical necessity and…
$81,967.12 - $122,950.68 a year
1d

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UR Coordinator, Full Time
RiverVista Behavioral Hospital —Columbus, OH
High school diploma required; associate or bachelor’s degree in nursing, healthcare administration, or related field preferred. Must be 21 or older.
$24 - $32 an hour
Quick Apply
Customer Service Assistant 2
State of Ohio - Unemployment Compensation Review Commission —Columbus, OH
Support and assist hearing officers by taking incoming calls for scheduled telephone hearings. Independently handles incoming inquiries via telephone or…
$23.65 - $27.56 an hour
4d

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appeals jobs near lexington park, md

APPEALS COORDINATOR

Calvert Health System -
Prince Frederick, MD

Quick Apply

Job Details

Part-time
$35 - $50 an hour

Qualifications

TJC
Nursing
Electronic health records (EHR) management
RN License
Spreadsheets
Word embeddings
Bachelor's degree
Desktop applications
Productivity software
Clinical documentation standards
Healthcare reimbursement methods
Hospital regulatory compliance
Documentation review
Hospital experience
Nursing

Full Job Description

JOB DESCRIPTION DETAILS
- Job Summary:
  - Responsible for the management and communication of denials/appeals received from third party payers, managed care companies, and/or government entities related to medical necessity and/or level of care. This associate will be a liaison and point of contact for clinical denials and appeal inquiries. The Appeals Coordinator will review each case identified/referred for appeal based on Milliman Care Guidelines (MCG) or InterQual guidelines, determine the viability of the appeal, and manage the appeal process. The RN Clinical Appeals Nurse will actively manage, maintain and communicate denial/appeal activity to appropriate stakeholders, and report suspected or emerging trends related to payer denials. Working with department leaders, this individual will coordinate education and other performance improvement initiatives to mitigate lost revenue related to medical necessity denials. Key Performance and trends related to denials/appeals will be reported to the facility.
- Education:
  - Position requires a Bachelor's degree and Registered Nurse Licensure.
- Registration/Certification/Licensure:
  - State Registered Nurse Licensure
- Experience:
  - Minimum 3+ year's experience in Utilization Review and/or Case Management, and 3 years in a clinical setting.
- Other Requirements:
  - Maintains unit-specific and hospital competencies, mandatory learning, and any clinical certifications required in accordance with the Staff Education and Training policy GA-057 and/or any other department requirements.
  - Intermediate skill level on the computer: Office Products including Word, Excel, and PowerPoint.
  - Demonstrates skills in planning, organizing, and managing multiple functions and complex processes.
  - Competent in Joint Commission Standards, Federal and State requirements relating to required documentation for the electronic health record to maintain compliance.
  - Knowledge of revenue cycle operations including state and federal reimbursement policies

Location: Calvert Health System · CMC PT FIN SERVICES
Schedule: Part Time, Day Shift, Part time

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appeals jobs in lexington park, md

APPEALS COORDINATOR

Asst Living Act Asst Non-Lic

Food Service Worker - Chesapeake Shores Nursing Center - Food

Activities Asst Non-Lic

Physical Therapy Front Desk Coordinator

Early Childhood Teacher - PAC

Asst Living Act Asst Licensed

Pizza Line Cook

Director of Development

Maintenance Manager

Host/Hostess

Fractional Healthcare & Regulatory Counsel

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