- Guardian Life (Bethlehem, PA)
- …Group Disability claims experience to join our dynamic Appeals Team. The ** Appeals Case Manager II ** (ACM 2) is responsible for adjudicating assigned ... role supports Group Short-Term Disability, Long-Term Disability and Life Waiver of Premium appeals . You are A highly motivated and reliable individual who can work… more
- Sharp HealthCare (San Diego, CA)
- …Status** Regular **Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** Accredited Case Manager (ACM) - American Case Management Association (ACMA); ... Nurse (RN) - CA Board of Registered Nursing; Certified Case Manager (CCM) - Commission for ...in the electronic medical record (EMR) and other supporting case management software.The RN CM II will… more
- City of Norfolk, Virginia (Norfolk, VA)
- Assistant Commonwealth Attorney I, II , and III Print (https://www.governmentjobs.com/careers/norfolk/jobs/newprint/2506461) Apply Assistant Commonwealth Attorney ... I, II , and III Salary See Position Description Location Norfolk,...Attorney I: + Prepares cases for trial by reviewing case reports, identifying the relevant facts of the … more
- State of Colorado (Morgan County, CO)
- CPW PHY/SCI/RESEARCHER SCIENTIST II / Microbiologist II (Brush, CO) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4798126) Apply CPW ... PHY/SCI/RESEARCHER SCIENTIST II / Microbiologist II (Brush, CO) Salary $74,604.00...(virology, bacteriology, parasitology, and molecular); (d) assist with accessioning case history paperwork, create, develop, or modify forms and… more
- State of Colorado (Golden, CO)
- Behavioral Health Specialist, Social Work/Counselor II - Betty K. Marler Youth Services Center Print ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4812548) Apply Behavioral Health Specialist, Social Work/Counselor II - Betty K. Marler Youth Services Center Salary… more
- LA Care Health Plan (Los Angeles, CA)
- …log and keep track all due dates for each file. Inform nurses of a new case received from Grievance and Appeals Specialist.; submit all Grievances and Appeals ... Authorization Technician II Job Category: Clinical Department: Utilization Management Location:...required by clinical staff to render decisions, assists the Manager and Director of the Utilization Management department in… more
- State of Colorado (Lakewood, CO)
- Administrative Assistant II - MVIU (Hybrid) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4814699) Apply Administrative Assistant II - ... customer service oriented individual to be our Administrative Assistant II in our MVIU! You'll be answering calls from...then this job may be for you! Primary Duties: Case Intake Management - + Reviews all case… more
- State of Colorado (Pueblo, CO)
- SOCIAL WORK/COUNSELOR II Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4800337) Apply SOCIAL WORK/COUNSELOR II Salary $73,464.00 - ... and part time Colorado Mental Health Hospital in Pueblo (CMHHIP) Social Work/ Counselor II Full Time As a cornerstone of the Pueblo community for over a century,… more
- State of Colorado (Adams County, CO)
- CPW Marketing & Communications Specialist II - CORA Records Assistant (Denver, CO) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4813678) ... Apply CPW Marketing & Communications Specialist II - CORA Records Assistant (Denver, CO) Salary $49,848.00...The CORA Records Assistant will support the CORA Records Manager in the processing of Colorado Open Records Act… more
- WellSpan Health (York, PA)
- Patient Financial Services Representative II - Govt Billing - Days Location: WellSpan Health, York, PA Schedule: Full Time General Summary Completes assigned revenue ... researches claim denial for resolution and submits disputes and appeals . Represents the System in a professional manner while...within 1 year Required or + Certified Patient Accounts Manager within 1 year Required or + Certified Coding… more
- State of Massachusetts (Boston, MA)
- …to parties in accordance with Massachusetts Employment Security Law. Assist unit manager in the operations of the department. This position requires a combination ... stating the conclusion, and the effect of the determination *3. *Conducts regular case reviews and discussions with staff to develop and enhance their capacity and… more
- MyFlorida (Tallahassee, FL)
- INVESTIGATION SPECIALIST II - 41500119 1 Date: Jan 30, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... No: 845880 Agency: Florida Gaming Control Commission Working Title: INVESTIGATION SPECIALIST II - 41500119 1 Pay Plan: Career Service Position Number: 41500119… more
- State of Colorado (Denver, CO)
- Operating Permit Unit Supervisor - PE II - HYBRID Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4813961) Apply Operating Permit Unit ... Supervisor - PE II - HYBRID Salary $8,748.00 - $12,922.00 Monthly Location...legislation, rules and requirements. Coordinate with the Permitting Program Manager and other Operating Permit Supervisor(s) on all management… more
- Medical Mutual of Ohio (OH)
- …outbound calls to members, providers, and pharmacies to initiate coverage determinations/ appeals , prescription refills, and switch members to lower cost therapeutic ... with a strong focus on member experience. Conducts outreach to Pharmacy Benefit Manager (PBM) for refills, claim reprocessing and to members to provide status of… more
- Clark County, NV (Las Vegas, NV)
- …is seeking qualified candidates for the position of Family Mediation Specialist I/ II . The Family Mediation Specialist I/ II provides professional services to ... This class is alternately staffed with Family Mediation Specialist II and incumbents may advance to a higher level...duties. This class is distinguished from the Family Mediation Manager in that the latter supervises and manages all… more
- Hackensack Meridian Health (Hackensack, NJ)
- …d. Clarifying ambiguous or conflicting documentation e. Target DRGs Reviews f. Use of case manager as a resource + Uses guidelines to evaluate patient status ... not limited to utilization review, hospital reimbursement, clinical compliance, case management, and transitions of care, as outlined in...reduce clinical denials by: I. Peer-to Peer (P2P) Concurrent appeals ii . Written Concurrent appeals … more
- Hackensack Meridian Health (Hackensack, NJ)
- …iii. Clarifying ambiguous or conflicting documentation iv. Target DRGs Reviews v. Use of case manager as a resource 4. Uses guidelines to evaluate patient status ... but are not limited to utilization review, hospital reimbursement, clinical compliance, case management, and transitions of care, as outlined in the responsibilities… more
- State of Massachusetts (Boston, MA)
- …The Executive Assistant will supervise the Docket Clerk in the Hearing and Appeals Unit. *Duties and Responsibilities:*(these duties are a general summary and not ... working in a professional Legal or Government setting as an Office Manager , Paralegal or Executive Assistant or other administrative position. * Superior… more
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