Appeal Resolution Specialist jobs in Pine Bluff, AR

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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Monitoring specialist
  • HealthCare Resolution Services
  • Bluff, AR FULL_TIME
  • JOB DESCRIPTION :

    Delivers remote patient monitoring and tele-health solutions for healthcare providers throughout the US. Our patient engagement software and services enable physicians to monitor and manage their patients' chronic conditions between office visits without investing in additional staff or money.

    By combining state of the art technology with a long history of expertise in the healthcare industry, HCRS & MagnatelMD are transforming medical practices.

    HCRS & MagnatelMD needs Medical Assistants to manage patients with chronic conditions by enrolling them in our remote patient monitoring program.

    The device provided transmits their medical data remotely. As the Patient Care Assistant, you contact the patient regularly to review their medical data received.

    JOB SKILLS :

    • Remain up-to date of CMS regulations.
    • Educate and encourage patient on program.
    • Provide onsite or scheduled group, and / or individual training sessions for potential patients.
    • Document patient conversation and instructions, orders, or recommendations clearly and concisely in the EMR.
    • Enroll patients into the Remote Patient Monitoring Program that have been referred to by provider or generated from the EMR.
    • Review patient data regularly and call patients on from the Monitoring platform; priority is given to red flag symptoms and non- compliant patients.

    Escalating trends of concern.

    • Educate patients on self-management skills and goal setting. These are patients with chronic conditions such as : Diabetes, CHF, COPD / Asthma, Hypertension, CAD,
    • Establish and maintain positive relationships with all internal and external customers.
    • Acts as a liaison for assigned patients with physicians' office.
    • Utilize Motivational Interviewing or other behavior change techniques to coach and assist the patient with self-management.
    • Engage patients to collaborate on optimal management of their chronic conditions.
    • Communicates with providers and staff regarding patient needs and follows up as appropriate.
    • Maintains compliance with standards, competencies, policies and procedures, proper documentation in the electronic medical record.
    • Provide inventory management to all medical equipment.
    • Provide weekly reports of patient and platform results.
    • Possible travel between provider's offices to provide support to teammates.
    • Performs other duties as required.
    • Stay in compliance with program by utilizing reimbursable activities with the patients which include patient's use of their device daily and time spent interacting with the patient in person or via telephone.

    Additional ways to communicate to patient are available as well.

    MINIMUM QUALIFICATIONS :

    • A Certified Medical Assistant
    • At minimum of two (2) years of experience in a clinical setting
    • Experience with Microsoft 365, Teams, and electronic medical records systems such as : E-clinical, Athena or NextGen
    • Ability to work independently with minimal direction.
    • Exceptional critical thinking skills
    • Extraordinary attention to detail
    • Must act with honesty and integrity.
    • Great time management
    • Great public speaking skills a plus
    • Last updated : 2024-04-07

  • 8 Days Ago

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Administrative specialist
  • University of Arkansas at Pine Bluff
  • Bluff, AR FULL_TIME
  • Summary of Job Duties To assist the athletic department in all phases of event operations, recruiting, fund raising, athletic department development, camps and other duties as assigned in support of t...
  • 10 Days Ago

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Literacy specialist
  • Arkansas Department of Education
  • Hampton, AR FULL_TIME
  • Job DescriptionThe Hampton School District is seeking qualified candidates for the position ofDyslexia / Literacy Specialist - Grade level K-12All certified personnel shall hold a current, valid Arkan...
  • 10 Days Ago

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Nursery Specialist
  • ArborGen
  • Bluff, AR FULL_TIME
  • ArborGen’s Nursery in Bluff City, AR has a position open for a Nursery Specialist. This facility produces 45 million bareroot pine and hardwood seedlings annually. The Nursery Specialist is required t...
  • 11 Days Ago

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Service Specialist
  • Pactiv Evergreen
  • Bluff, AR FULL_TIME
  • Overview Service Specialist|Pine Bluff| HIRING IMMEDIATELY Incentives: Pay: starting out at $22.90 hour Benefits: comprehensive benefits package (see further details below) Opportunity: career growth ...
  • 11 Days Ago

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Math Specialist
  • Southeast AR Educ Service Center
  • Monticello, AR FULL_TIME
  • ● Facilitate adult learning situations and team problem solving ● Create and lead professional development ● Have current knowledge of research and effective practices in the area of math instruction,...
  • 13 Days Ago

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0 Appeal Resolution Specialist jobs found in Pine Bluff, AR area

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ADMINISTRATIVE SPECIALIST I
  • Arkansas Government Job
  • Tucker, AR
  • ADMINISTRATIVE SPECIALIST I Date: Mar 19, 2024 Req ID: 38358 Location: Tucker, AR, US, 72168 Category: DEPARTMENT OF COR...
  • 4/18/2024 12:00:00 AM

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Data Entry Specialist (Work From Home)>
  • CareMetx
  • Pine Bluff, AR
  • [Administrative Assistant / Fully Remote] - Anywhere in U.S. / Competitive Pay - As a Data Entry Specialist you'll: Main...
  • 4/18/2024 12:00:00 AM

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FISCAL SUPPORT SPECIALIST
  • Arkansas Department of Health
  • Pine Bluff, AR
  • to apply! ** FISCAL SUPPORT SPECIALIST** Date: Mar 5, 2022 Req ID: 11956 Location: Pine Bluff, AR, US, 71601 Category: D...
  • 4/17/2024 12:00:00 AM

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Outreach Specialist
  • Arkansas Medical Society
  • Little Rock, AR
  • Provider Outreach Specialist Job Description Overview: The position will support the AMS membership in understanding and...
  • 4/16/2024 12:00:00 AM

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Service Specialist
  • Pactiv Evergreen
  • Pine Bluff, AR
  • Overview: Service Specialist|Pine Bluff| HIRING IMMEDIATELY Incentives: Pay: starting out at $22.90 hour Benefits: compr...
  • 4/15/2024 12:00:00 AM

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ADAS Calibration & Diagnostic Specialist
  • Hiring Now!
  • Sweet Home, AR
  • Champions Do More At Automotive Technology Experts (ATE), we understand the importance of providing fast and accurate ve...
  • 4/14/2024 12:00:00 AM

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ADAS Calibration & Diagnostic Specialist
  • Hiring Now!
  • College Station, AR
  • Champions Do More At Automotive Technology Experts (ATE), we understand the importance of providing fast and accurate ve...
  • 4/14/2024 12:00:00 AM

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Entry Level Sales Representative - BASE + COMMISSION
  • True Network Solutions
  • Pine Bluff, AR
  • Job Description Job Description Entry Level Sales Representative – Base + Commission Job Description Position Summary Do...
  • 4/14/2024 12:00:00 AM

Pine Bluff is the tenth-largest city in the state of Arkansas and the county seat of Jefferson County. It is the principal city of the Pine Bluff Metropolitan Statistical Area and part of the Little Rock-North Little Rock-Pine Bluff Combined Statistical Area. The population of the city was 49,083 in the 2010 Census with 2017 estimates showing a decline to 42,984. The city is situated in the Southeast section of the Arkansas Delta and straddles the Arkansas Timberlands region to its west. Its topography is flat with wide expanses of farmland, consistent with other places in the Delta Lowlands....
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Appeal Resolution Specialist jobs
$42,664 to $52,853
Pine Bluff, Arkansas area prices
were up 1.2% 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