- VNS Health (Manhattan, NY)
- OverviewManages the day to day activities for staff handling of grievances and appeals for one of the following VNS Health Plans product lines - Managed Long ... subcontractors who have delegated responsibility for managing grievance and appeals on behalf of the plan to ensure operational...paid time off and 9 company holidays + Health insurance plan for you and your loved ones, Medical,… more
- CVS Health (Atlanta, GA)
- …and affordable. **Position Summary** This position supports the daily processing of appeals in the Commercial Member Clinical Appeals (CMCA). Job functions ... the panel hearing process, working collaboratively with clinical support staff (Medical Directors, Nurses, Providers, etc.), triage of faxes,...faxes, and movement of cases in the Complaints and Appeals Tracking System (CATS). All work is to be… more
- VNS Health (Manhattan, NY)
- OverviewResolves grievances, appeals and external reviews for VNS Health Plans product lines - Managed Long Term Care (MLTC), Medicare Advantage (MA), Fully ... decision. Develops correspondence communicating the outcome of grievances and appeals to enrollees and/or providers. Assists with collecting and...paid time off and 9 company holidays + Health insurance plan for you and your loved ones, Medical,… more
- CVS Health (Tallahassee, FL)
- …Summary** Coordinate effective resolution of member and/or provider/practitioner appeals , complaints and grievances. Responsible for the day-to-day management ... of staff to ensure effective resolution of member or provider/practitioner appeals , complaints and grievances for all products, which may contain multiple issues… more
- VNS Health (Manhattan, NY)
- OverviewResolves grievances, appeals and external reviews for one of the following VNS Health Plans product lines - Managed Long Term Care (MLTC), Medicare Advantage ... decision. Develops correspondence communicating the outcome of grievances and appeals to enrollees and/or providers. Assists with collecting and...paid time off and 9 company holidays + Health insurance plan for you and your loved ones, Medical,… more
- Point32Health (MA)
- …develop, and mentor staff in the accurate and timely management of Appeals and Grievances. + Partner with the Appeals and Grievances Program Management ... . **Job Summary** Under the general direction of the Senior Manager of Appeals and Grievances the Appeals and Grievance Supervisor, through the use… more
- Elevance Health (Indianapolis, IN)
- **Title: Grievance/ Appeals Analyst I** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of one of ... our PulsePoint locations. The **Grievance/ Appeals Analyst I** is an entry level position in...approve or summarize and route to nursing and/or medical staff for review. + The grievance and appeal work… more
- Elevance Health (Richmond, VA)
- **Title: Grievance/ Appeals Analyst Lead** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of a ... California PulsePoint location. The **Grievance/ Appeals Analyst Lead** will be responsible for leading and...approve or summarize and route to nursing and/or medical staff for review. **Minimum Requirements** + HS diploma or… more
- Elevance Health (Los Angeles, CA)
- **Title: Grievance/ Appeals Analyst I** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of one of ... our PulsePoint locations. The **Grievance/ Appeals Analyst I** is an entry level position in...approve or summarize and route to nursing and/or medical staff for review. + The grievance and appeal work… more
- Elevance Health (Norfolk, VA)
- **Grievance/ Appeals Analyst Lead** **Candidates must be located within 50 miles of Atlanta, GA, Miami, FL, Mason, OH, Norfolk, VA, Tampa, FL, or Topeka, KS** The ... **Grievance/ Appeals Analyst Lead** is responsible for leading and coaching...approve or summarize and route to nursing and/or medical staff for review. **Minimum Requirements:** + Requires a high… more
- CVS Health (Salem, OR)
- …Management Staff * Participate in ongoing initiatives to improve appeals team efficiency and clinical consistency **Required Qualifications** * Two (2) or ... of this Medical Director role are related to Medicare Appeals . * Direct daily work on part C ...eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long… more
- New York State Civil Service (Melville, NY)
- NY HELP Yes Agency Insurance Fund, State Title Assistant Attorney 2/ Assistant Attorney 3 / Senior Attorney - Appeals (NY HELPS) Occupational Category Legal ... termination or suspension of employment.Please be advised that the New York State Insurance Fund does not offer sponsorship for employment visas to employees or… more
- Houston Methodist (Houston, TX)
- …S Fry Katy, TX 77450** **Looking for candidates with the following:** + ** Appeals with hospital accounts** + **Epic experience is a plus** + **Government Advantage ... Revenue Cycle experience** At Houston Methodist, the Accounts Receivable (AR) Appeals Denials Specialist position is responsible for reviewing accounts which have… more
- MTA (Brooklyn, NY)
- Deputy Executive Assistant General Counsel ( Appeals ) Job ID: 8104 Business Unit: New York City Transit Location: Brooklyn, NY, United States Regular/Temporary: ... Oct 2, 2024 Description Job Information Deputy Executive Assistant General Counsel ( Appeals ) Open Date: 7/11/2024 Close Date: Open Until Filled Authority: TA… more
- University of Utah (Salt Lake City, UT)
- …**Preferences** + Demonstrated knowledge of revenue cycle. + Working knowledge of insurance denials, appeals and expected reimbursement rates. + Experience ... PRN40045B **Job Title** Outpatient/Provider Coder Level 3 **Working Title** Medical Appeals Coding Specialist SR **Job Grade** E **FLSA Code** Nonexempt **Patient… more
- Humana (Columbus, OH)
- …The Medical Director relies on broad clinical expertise to review Medicare drug appeals (Part D & B). The Medical director work assignments involve moderately ... and medical necessity. The Medical Director will collaborate with clinicians and support staff to provide Humana members with optimal value based care in accordance… more
- TEKsystems (Boise, ID)
- …and payors to support our clients. If you have experience working within medical insurance roles handling claims, payer portals, appeals , AR follow up, denials ... cycle specialist on our team you will be verifying insurance information, following up, doing research on insurance...regarding patient financial care services and resources to patients, staff , payors, and agencies * Work with Claims and… more
- CVS Health (Columbus, OH)
- …closure audits as well as policy and Job Instruction updates and staff education **Required Qualifications** Compliance experience Audit Experience Grievance and ... Appeals Experience **Preferred Qualifications** **Education** High School Diploma or...eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long… more
- Mount Sinai Health System (New York, NY)
- …collaboratively with physicians and managed care companies on concurrent denial appeals * Communicates clinical information to the payor, as needed, coordinating ... requiring Residential Health Care Facility placement. * Assist in having appropriate staff complete discharge forms in a timely manner. * Coordinates the Discharge… more
- State of Minnesota (St. Paul, MN)
- **Working Title: Senior Associate General Counsel** **Job Class: Staff Attorney 3** **Agency: Human Services Dept** + **Job ID** : 81231 + **Location** : St. Paul + ... data privacy and protected health information, Medicaid, litigation and administrative appeals , and policy development. **Responsibilities include but may not be… more