- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Clinical Appeals Supervisor (RN) directs and coordinates the accurate implementation of the clinical appeal ... the activities and serves as a resource for associates within the Clinical Appeals and Analysis unit supporting Government Programs lines of business. We are… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor , Appeals and Grievances Clinical Operations RN Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, ... support the safety net required to achieve that purpose. Job Summary The Supervisor of Appeals and Grievances Clinical Operations (A&G) RN is responsible for… more
- RWJBarnabas Health (Oceanport, NJ)
- Supervisor , Appeals , Remote, NJReq #:0000176996 Category:No Category Assigned Status:Full-Time Shift:Day Facility:RWJBarnabas Health Corporate Services ... 2 Crescent Place, Oceanport, NJ 07757 Job Overview: The Supervisor is responsible for managing technical and clinical...primarily responsible to ensure the staff is properly validating clinical and technical denials to ensure appeals … more
- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Supervisor , Grievances & Appeals is an inventory based role, supporting a team of ... This position will also support quality related go The Supervisor , Grievances & Appeals is an inventory...4 - 6 years of customer service experience + Clinical background experience (for example CNA/ LPN) + Minimum… more
- Alameda Health System (San Leandro, CA)
- Care Management Clinical Appeals Specialist + San Leandro, CA + Finance + Patient Financial Svcs - Facil + Full Time - Day + Business Professional & IT + Req ... and executes the appeal process for all AHS facilities clinical appeals and third party audits. **DUTIES...Initiates the appeal process, at the direction of the Supervisor and/or physician advisors, until the case is overturned,… more
- Glens Falls Hospital (Glens Falls, NY)
- …**Job:** **Allied Health - Health Information Management* **Title:** *Coding Reimbursement Appeals Supervisor - Health Information Management (HIM) * ... but with emphasis on Inpatient Coding. Collaborates with Professional Coders, Clinical Document Improvement Specialists, "Scrubber" Edit Specialists and Providers to… more
- Guidehouse (Birmingham, AL)
- …to Insurance Companies to resolve claim denials and account balances. + Performing Non- Clinical Appeals . + Assisting Supervisor /Manager as needed with ... various projects. + Escalate payer issues/trends to a supervisor with the appropriate information or take appropriate action...+ 0-2 years medical provider experience working with UB04, appeals & denials. **What Would Be Nice to Have**… more
- City and County of San Francisco (San Francisco, CA)
- …looks like in action. Under general direction, the Medical Social Work Supervisor works for the Department Disability and Aging Services Hub. This position ... and Class 2940 Protective Services Worker staff. Along with supervision, this supervisor provides consultation concerning the most difficult cases and serves as… more
- State of Colorado (Canon City, CO)
- CDOC (Social Worker/Counselor IV) Mental Health Supervisor - Canon City (CTCF) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4743252) Apply ... CDOC (Social Worker/Counselor IV) Mental Health Supervisor - Canon City (CTCF) Salary $7,087.00 - $9,922.00...of Corrections Mission: $25,000 HIRING INCENTIVE FOR FULL TIME CLINICAL PROFESSIONALS! If your goal is to build a… more
- State of Colorado (CO)
- …for a smaller clinic, a shift within a larger complex facility, or a supervisor in a specialized clinical treatment unit. This position may be required ... CDOC Nurse Supervisor Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4383689) Apply CDOC Nurse Supervisor Salary $8,204.00 - $11,487.00… more
- State of Colorado (Pueblo, CO)
- Occupational Therapist Supervisor - Therapist IV Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4506134) Apply Occupational Therapist ... Supervisor - Therapist IV Salary $98,000.00 Annually Location Pueblo,...care in groups or individualized treatment sessions + Provide clinical and administrative supervision to OT staff providing OT… more
- State of Colorado (Denver, CO)
- …the social work department and in collaboration with leadership. As a student supervisor , Social Worker III is responsible for clinical and administrative ... Social Worker III (Forensics) - Clinical Services - Colorado Mental Health Hospital in...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- Select Medical (Dallas, TX)
- …A joint venture with Select Medical & Baylor Scott & White Health Dallas, TX ** Clinical Liaison (RN, OT, PT, or SLP)** **Full-Time, Monday through Friday 8am - 5pm** ... **Competitive base salary with monthly bonuses!** Clinical Liaisons are advocates who educate and guide patients toward the next level of care, while building… more
- Select Medical (O'Fallon, MO)
- …Transitional Center St. Louis, MO New Location Opening quarter 1 of 2025 ** Clinical Liaison (RN, OT, PT, or SLP)** **Full-Time** **Competitive base salary with ... monthly bonuses!** Clinical Liaisons are advocates who educate and guide patients...Obtaining insurance approvals and authorizations, as well as facilitating appeals for patients + Demonstrates positive referrer satisfaction and… more
- Hackensack Meridian Health (North Bergen, NJ)
- …healthcare and serve as a leader of positive change. The ** Supervisor , Care Management** integrates and coordinates utilization management, care coordination, ... functions and performance improvement activities for all care managers. The Supervisor , Care Management is accountable for oversight of the department's designated… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor , Authorization Technician Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... the safety net required to achieve that purpose. Job Summary The Supervisor , Authorization Technician supports the Utilization Management (UM) Specialist by handling… more
- VNS Health (Manhattan, NY)
- …of member UAS-NY for potential new members and existing members' conditions clinical , environmental, and social to establish an individual plan of care needed ... from providers, members, and care management team and renders clinical determinations in accordance with VNS Health Plans policies...a safe member centered service plan + Consult with supervisor and others in overcoming barriers in meeting goals… more
- Rush University Medical Center (Chicago, IL)
- …than 0.5) **Shift:** **Shift 1** **Work Schedule:** 8 Hr **Summary:** The Clinical resource coordinator (CRC) applies a collaborative approach in working with ... designated support for functions including payer approval / certification communication, denial appeals , and / or level of care management processes. * In accordance… more
- Houston Methodist (Houston, TX)
- …required to perform collections activities on complex denials and prepare complex appeals on outstanding insurance balances in the professional fee environment. This ... other team members as advised by the Manager and/or Supervisor . + Identifies denial trends and notifies Supervisor...complex payers and resolve accounts. + Manages denials and appeals efforts. Creates and submits appeals when… more
- UNC Health Care (Chapel Hill, NC)
- …that have opted into shared services. This position reports to the HCS Supervisor Coding and CDI Quality and Training. This position provides mentoring and training ... coder questions and provide training and education. This position processes and appeals insurance coding denials. This position analyzes coded records for compliance… more