Appeal Resolution Specialist jobs in Lawrence, MA

Appeal Resolution Specialist logs, tracks, and processes appeals and grievances. Sets up and maintains case files for each grievance and collects the information required by organizational policies and applicable regulations. Being an Appeal Resolution Specialist conducts research and coordination needed to evaluate, process, respond to, and refer or close appeals. May require an associate degree or equivalent. Additionally, Appeal Resolution Specialist typically reports to a supervisor. The Appeal Resolution Specialist works under moderate supervision. Gaining or has attained full proficiency in a specific area of discipline. To be an Appeal Resolution Specialist typically requires 1-3 years of related experience. (Copyright 2024 Salary.com)

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Claims Resolution Specialist
  • IWP
  • Andover, MA FULL_TIME
  • We are seeking a high-energy, goal-oriented Claims Resolution Specialist to join our growing team in Andover, Massachusetts. Under general supervision, the Claims Resolution Specialist performs a variety of professional duties in support of IWP’s pharmacy services. This position is responsible for expediting payment from workers’ compensation insurance carriers, monitoring electronic billing rejections, and maintaining accounts receivable. This is a phone-based position, Monday through Friday, from 8:30 am to 5:00 pm.

     

    What You'll Do

    • Review, investigate, and analyze claims to maximize recovery
    • Monitor electronic billing rejections and take appropriate action
    • Ensure proper filing of invoices and monitor billing statuses less than 60 days outstanding
    • Develop and maintain internal systems for data collection and entry, financial analysis, and report generation; create and update spreadsheets and logs as necessary
    • Serve as a liaison between insurance carriers, pharmacy benefit managers, patients, and internal company divisions
    • Negotiate settlements with insurance carriers within their granted settlement authority level as needed
    • Pursue subrogation and arrange for salvage to obtain maximum recovery

    What You'll Need to Succeed

    • Knowledge of medical terminology
    • An investigative mind and outstanding attention to detail
    • Solid grasp of report generation and analysis
    • Collections, claims processing, and subrogation experience a plus
    • Workers’ compensation knowledge a plus

    Make a Difference with IWP

    Injured Workers Pharmacy (IWP) is proud to be THE Patient Advocate Pharmacy, helping injured workers around the country access their prescription medications with ease. As a specialized workers’ compensation home delivery pharmacy, we collaborate with the legal, medical, and insurance communities to help injured workers return to a productive life. At IWP we believe in our service, but it’s the people who make it a great place to work. We value our employees and strive for a culture of teambuilding, open mindedness, and fun. If that sounds like something you’d like to be part of, we’d love to hear from you! Your compensation will include a competitive salary, generous benefits, and opportunities for growth and development.

     

    IWP is an Equal Opportunity Employer.  IWP does not discriminate on the basis of race, creed, color, religion, national origin, sex, sexual orientation, gender identity, age, physical or mental disability, or any other basis covered by appropriate law.  All employment decisions are made on the basis of qualifications, merit, and business need. IWP is committed to providing reasonable accommodations for qualified individuals with physical and mental disabilities in our job application procedures. If you need assistance or an accommodation due to a disability, you may contact us at humanresources@IWPharmacy.com   We will make a determination on your request for reasonable accommodation on a case-by-case basis.

  • 15 Days Ago

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Conflict Resolution Specialist - High School Level (FT)
  • Haverhill Public Schools
  • Haverhill, MA FULL_TIME
  • PLEASE POSTPLEASE POSTHAVERHILL PUBLIC SCHOOLSHAVERHILL, MASSACHUSETTS 01830-ANTICIPATED OPENING-HAVERHILL PUBLIC SCHOOLS IS A DIVERSE ENVIRONMENT AND IS PROUD TO BE AN EQUAL OPPORTUNITY EMPLOYER. ALL...
  • 22 Days Ago

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Conflict Resolution Specialist High School Level
  • Haverhill Public Schools
  • Haverhill, MA FULL_TIME
  • PLEASE POST PLEASE POST HAVERHILL PUBLIC SCHOOLSHAVERHILL, MASSACHUSETTS 01830-ANTICIPATED OPENING- HAVERHILL PUBLIC SCHOOLS IS A DIVERSE ENVIRONMENT AND IS PROUD TO BE AN EQUAL OPPORTUNITY EMPLOYER. ...
  • 1 Day Ago

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Talent Acquisition Specialist
  • Talent Acquisition Specialist
  • Andover, MA FULL_TIME
  • IWP is looking for a savvy Talent Acquisition Specialist to join our Human Resources team. Reporting to the Director of Human Resources, the Talent Acquisition Specialist will focus on managing and st...
  • 22 Days Ago

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Specialist
  • Kforce
  • Danvers, MA FULL_TIME
  • Kforce has a client that is seeking a T / E Specialist in Danvers, MA.Responsibilities : T / E Specialist will work on a small Accounting Operations team to support a T&E Project Assist with data clea...
  • 21 Days Ago

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Specialist
  • Apple
  • Salem, NH FULL_TIME
  • As a Specialist, you’re highly skilled at uncovering customers’ needs, then following through with enlightening solutions. Not only are you the first person customers meet when they enter the store, b...
  • 27 Days Ago

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0 Appeal Resolution Specialist jobs found in Lawrence, MA area

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ServiceNow Expert
  • Acro Service Corp
  • Boston, MA
  • Job Title: ServiceNow Expert Duration: 12 Months (With Possible Renewal) Location: Boston, MA (Hybrid- 4 Days per month ...
  • 3/28/2024 12:00:00 AM

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Vehicle Crash/Automotive Expert
  • Robson Forensic
  • Lowell, MA
  • Job Description Job Description VEHICLE CRASH EXPERT / AUTOMOTIVE EXPERT Do you want to use your training, education, an...
  • 3/28/2024 12:00:00 AM

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Field Expert
  • Moxie Pest Control
  • Canton, MA
  • Job Description Job Description URGENTLY HIRING/HIRING IMMEDIATELY Come be a part of the Moxie Family! Position: Field S...
  • 3/27/2024 12:00:00 AM

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Sleep Expert - Sales
  • Mattress Firm
  • Everett, MA
  • Now Hiring! Sleep Expert Sales Is your current job a nightmare? Make it a dream! Mattress Firm The most trusted authorit...
  • 3/25/2024 12:00:00 AM

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Expert Systems Analyst - Remote
  • Altera Digital Health Inc. United States
  • Burlington, MA
  • Altera, a new member of the N. Harris Computer Corporation family, delivers health IT solutions that support caregivers ...
  • 3/24/2024 12:00:00 AM

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Sleep Expert - Sales
  • Mattress Firm
  • Acton, MA
  • Now Hiring! Sleep Expert Sales This fast-paced, commission-driven sales role will provide you with everything you need t...
  • 3/24/2024 12:00:00 AM

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Sleep Expert - Sales
  • Mattress Firm
  • Everett, MA
  • Now Hiring! Sleep Expert – Sales Is your current job a nightmare? Make it a dream! Mattress Firm The most trusted author...
  • 3/18/2024 12:00:00 AM

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Sleep Expert - Sales
  • Mattress Firm
  • Acton, MA
  • Now Hiring! Sleep Expert – Sales This fast-paced, commission-driven sales role will provide you with everything you need...
  • 2/29/2024 12:00:00 AM

According to the United States Census Bureau, the city has a total area of 7.4 square miles (19 km2), of which 7.0 square miles (18 km2) is land and 0.4 square miles (1.0 km2) (6.07%) is water. Lawrence is on both sides of the Merrimack River, approximately 26 miles (42 km) upstream from the Atlantic Ocean. On the north side of the river, it is surrounded by Methuen. On the south side of the river, the town is bordered by North Andover to the east, and Andover to the south and southwest. Lawrence is approximately 30 miles (48 km) north-northwest of Boston and 27 miles (43 km) southeast of Manc...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Appeal Resolution Specialist jobs
$50,725 to $62,836
Lawrence, Massachusetts area prices
were up 1.6% from a year ago

Appeal Resolution Specialist in Colorado Springs, CO
As a Appeals Resolution Specialist, you will work directly with our Shared Service Centerproviding follow up to denied claims.
February 22, 2020
Appeal Resolution Specialist in Fort Smith, AR
Overcome objections that prevent payment of the claim and gain commitment forpayment through concise and effective appeal argument.
February 01, 2020
Appeal Resolution Specialist in Middlesex, NJ
Coordinate the overall process of complaint resolution, responding to all verbal and written complaints from members and/or providers relating to member eligibility and benefits, contract administration, claims processing, utilization management decisions, pharmacy and vision decisions.
January 25, 2020