32 appeals jobs at 29 companies in Colorado
6d
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Senior Appeals Analyst
Newark or Wisconsin or California or Colorado or Arkansas or Arizona or Alabama or District of Columbia or Florida or Connecticut or Georgia or Delaware or Iowa or Kansas or Indiana or Kentucky or Illinois or Idaho or Louisiana or Massachusetts or Maryland or Maine or North Dakota or Michigan or Mississippi or Washington or Texas or Missouri or Montana or North Carolina or Minnesota or New Hampshire or Oklahoma or Vermont or Nebraska or Tennessee or Nevada or New York or Ohio or Oregon or New Mexico or Pennsylvania or Rhode Island or South Dakota or Utah or South Carolina or West Virginia or Virginia or Wyoming
$67k-$110k/yr RemoteFull Time
3+ YOERequires 3–5 years of short- or long-term disability claims experience, strong analytical and communication skills, knowledge of ERISA and state requirements, and proficiency with claims and Microsoft Office tools.
Microsoft Office
2mo
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Medical Claims Denial & Appeals Specialist
Aurora, Colorado, United States
$25-$33/hr RemoteFull Time
3+ YOE3-5 years medical billing with denials/appeals; ICD-10/CPT skills; CPC certification preferred; strong communication and contract interpretation; Intermediate PC software experience.
ICD-10, CPT, CPC, Microsoft Excel, Microsoft Word
1w
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Appeals Registered Nurse
Madison or Colorado or Florida or Georgia or Illinois or Indiana or Iowa or Michigan or Minnesota or Missouri or Nebraska or New Jersey or North Carolina or Ohio or South Carolina or Texas or Virginia or Wisconsin
$66k-$68k/yr RemoteFull Time
1+ YOERequires ASN or BSN, active RN license, 1+ year clinical experience, medical review knowledge, strong communication and organizational skills, and proficiency with Microsoft Office systems.
Microsoft Outlook, Microsoft Teams, Microsoft OneNote, Microsoft Word, Microsoft Excel, Centers for Medicare & Medicaid Services (CMS)
3mo
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Appeals Technician (temp-to-hire)
United States or New York City or Denver
$60k-$65k/yr RemoteFull Time
1+ YOE1+ years as a certified pharmacy technician in PBM/managed care, active PTCB or NHA certification, strong attention to detail, excellent communication, ability to work 12pm-9pm EST in a remote, metric-driven environment.
JUDI
1d
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Care Coordinator - Clinical Appeals RN
United States or Washington or Alaska or Arizona or Arkansas or California or Colorado or Florida or Georgia or Idaho or Iowa or Kansas or Kentucky or Maine or Michigan or Minnesota or Missouri or Montana or Nevada or New Hampshire or New Mexico or North Carolina or Oklahoma or Oregon or South Carolina or South Dakota or Tennessee or Texas or Utah or Wisconsin
$80k-$126k/yr RemoteFull Time
3+ YOECurrent registered nurse license, bachelor's degree or four years' work experience, and three years of clinical experience required; utilization management and health plan experience required or preferred.
Milliman Care Guidelines
4w
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Appeals and Grievances Clinical Specialist
New York City or Lake Mary or New York or North Dakota or Indiana or Virginia or Texas or Tennessee or South Carolina or Pennsylvania or Ohio or Nevada or New Jersey or North Carolina or Minnesota or Maryland or Massachusetts or Kansas or Illinois or Iowa or Georgia or Florida or Delaware or Connecticut or Colorado or New Hampshire or Vermont or Arizona or Alabama or Maine or Utah or Mississippi or Montana or South Dakota or Nebraska or New Mexico or Washington or Michigan or Oklahoma
$73k-$120k/yr RemoteFull Time
Active registered nurse (rn) required; experience in appeals & grievances, utilization review, claims processing preferred; familiarity with Utilization Review guidelines and care management systems; strong documentation and case management skills.
Microsoft Word, Microsoft Excel, Macess, CCMS, TruCare, Hyland, InterQual, Milliman
1mo
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Sr. Manager, Pricing - Pharmacy Appeals
Arizona or Idaho or Arkansas or Vermont or Georgia or Texas or Minnesota or New Mexico or Montana or Iowa or Michigan or Oregon or Maine or Wisconsin or New York or North Dakota or Kansas or New Jersey or Nebraska or Indiana or Connecticut or Nevada or Rhode Island or Louisiana or Kentucky or Tennessee or Mississippi or Ohio or Oklahoma or West Virginia or Massachusetts or Maryland or South Carolina or Alabama or Missouri or Utah or Virginia or South Dakota or Illinois or North Carolina or Florida or Colorado or Pennsylvania or New Hampshire or Wyoming or Delaware
$68k-$183k/yr RemoteFull Time
7+ YOE5+ Mgmt7 years experience in pricing/PBM/healthcare operations or related domains; 5+ years leading operations teams; 1+ year appeals and claims adjudication experience; Bachelor's degree or equivalent; proficiency with Excel, MS Access, Salesforce; strong analytical and leadership skills.
Microsoft Excel, MS Access, Salesforce, Pharmacy Portal
1d
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Grievance & Appeals Claims Specialist - Denver Health Medical Plan (Must Live in Colorado. Weekly On Site Requirement.)
Denver, Colorado, United States
$24-$34/hr HybridFull Time
1+ YOEHigh school diploma or GED and claims, customer service, or grievance experience required. Requires strong communication, analytical, organizational, and problem-solving skills; associate degree preferred.
QNXT
1mo
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Remote Medical Director, Appeals
Missouri or New Mexico or Arizona or Utah or Washington or Colorado or Oregon or Nevada or California
$237k-$449k/yr RemoteFull Time
MD or DO with active state medical license, board certification, utilization management experience preferred, current clinical practice, and knowledge of quality/accreditation standards.
1w
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Supervisory Internal Revenue Agent - Appeals Team Manager (MSP), (NTE 1 Yr, MBE 5 Yr, MBMP)
Anchorage or Birmingham or Phoenix or Tucson or Fresno or Lake Forest or Long Beach or Los Angeles or Sacramento or San Bernardino or San Diego or San Francisco or San Jose or Denver or Hartford or New Haven or Washington or Jacksonville or Miami or Plantation or Tampa or Atlanta or Honolulu or Honolulu or Des Moines or Boise or Chicago or Peoria or Fort Wayne or Indianapolis or South Bend or Florence or Louisville or New Orleans or Andover or Boston or Baltimore or Lanham or South Portland or Detroit or Grand Rapids or Saint Paul or Kansas City or Saint Louis or Jackson or Charlotte or Greensboro or Omaha or Portsmouth or Newark or Albuquerque or Las Vegas or Buffalo or Holtsville or New York City or Syracuse or Westbury or Cincinnati or Columbus or Independence or Oklahoma City or Portland or Philadelphia or Pittsburgh or Bayamon or Columbia or Knoxville or Memphis or Nashville or Austin or Farmers Branch or Houston or San Antonio or Ogden or Salt Lake City or Richmond or Seattle or Milwaukee or Bridgeport or Charleston
$126k-$197k/yr OnsiteFull Time, Temporary
1+ YOERequires CPA or bachelor's degree with accounting coursework, one year of specialized accounting or auditing experience, leadership capabilities, tax law knowledge, and current IRS competitive-service employment.
Leadership Succession Review (LSR), USA Hire, USA Staffing, Microsoft Excel
1mo
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Accounts Receivable Specialist (Hybrid)
Colorado Springs, Colorado, United States
$23-$29/hr HybridFull Time
Experience in medical billing, denial management and collections; eligibility and benefit checks; payer communication and appeals; strong problem-solving skills.
1mo
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Patient Advocate - Billing and Benefits
Denver, Colorado, United States
$58k-$80k/yr OnsiteFull Time
5+ YOE5+ years healthcare experience, proven medical billing/revenue cycle skills, familiarity with EOBs/SPDs and appeals, strong communication, and Microsoft Office proficiency.
Microsoft Office Suite
13h
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REGISTERED NURSE-Discharge planning
Craig, Colorado, United States
$34-$50/hr OnsitePart Time
Registered nurse responsible for discharge planning, utilization review, care coordination, medical necessity evaluation, insurance appeals, patient advocacy, and electronic medical record documentation.
InterQual, Milliman, Electronic Medical Record (EMR)
2w
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Utilization Review Specialist
Englewood, Colorado, United States
$26-$33/hr OnsiteFull Time
Bachelor's required (masters preferred). Knowledge of clinical criteria and managed care, ability to complete pre/re-certifications, communicate with payers and clinical teams, and manage appeals.
2w
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Biller Specialist
Grand Junction, Colorado, United States
OnsiteFull Time
Verify billing documentation, submit accurate invoices, follow up on denials and appeals, perform collections and account adjustments; proficiency with Excel and Word and basic medical terminology.
Microsoft Excel, Microsoft Word
2w
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Porter
Golden, Colorado, United States
$20-$22/hr OnsiteFull Time
Ability to perform physical labor up to 8 hours, lift 50 lbs, use hand and power tools, communicate in English, and maintain property cleanliness and curb appeal.
1w
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Participant Satisfaction Coordinator
Colorado Springs, Colorado, United States
$26-$29/hr OnsiteFull Time
2+ YOEHigh school diploma or equivalent and 2+ years in healthcare, long-term care, or social services; grievance, appeals, compliance, CMS, PACE, EHR, documentation, and analytical skills required.
Microsoft Office, Electronic Health Record (EHR)
1mo
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Reimbursement Coordinator I, Medicare
Dallas or Alaska or Alabama or Arkansas or Arizona or Colorado or Connecticut or Florida or Georgia or Idaho or Illinois or Indiana or Kansas or Kentucky or Louisiana or Massachusetts or Maryland or Missouri or Mississippi or Montana or North Carolina or New Mexico or Nevada or Ohio or Oklahoma or Oregon or Pennsylvania or Rhode Island or South Carolina or Tennessee or Texas or Utah or Virginia or Wyoming
$18-$21/hr RemoteFull Time
2+ YOE2 years home health/hospice or Medicare billing experience, high school diploma or equivalent, strong computer and typing skills, organized and detail-oriented for billing, collections, and appeals.
1mo
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Reimbursement Specialist II
California or Colorado or United States
$24-$33/yr RemoteFull Time
2+ YOE2+ years healthcare reimbursement experience; knowledge of billing processes, payer interactions, appeals (IRO/IRB) preferred; strong written/verbal communication, attention to detail, Excel proficiency.
Xifin, EDI, Microsoft Excel
5d
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Field Reimbursement Manager-Mountain West
New Mexico or Colorado or Wyoming or Nebraska or South Dakota or North Dakota
RemoteFull Time
7+ YOERequires 7+ years in healthcare, reimbursement, brand management, or sales; 2+ years in field reimbursement; buy-and-bill experience; claims analysis; payer coverage knowledge; and prior authorization and appeals experience.
HCPCS Level II, CPT, J-codes, ICD-10, CRM
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