- Catholic Health Services (Melville, NY)
- …Long Island's Top Workplace! Job Details Position Summary: The Utilization and Appeals Coordinator will perform activities to help facilitate utilization ... management and appeals functions to include coordination of specific process and payment related activities. Position Responsibilities: | Prepares necessary… more
- City of New York (New York, NY)
- …improving health and safety, and increasing opportunities for equitable growth. Your Team The Appeals Operations Coordinator will be a key member of the Division ... families with moderate and middle incomes. Your Impact As the Appeals Operations Coordinator for the Division of Adjudications, you will bolster effective… more
- Centene Corporation (Harrisburg, PA)
- …Purpose:** Analyze and resolve verbal and written claims and authorization grievance/ appeals from providers and members. Resolve all State inquires related to ... complaints, grievances and appeals . + Review and process member and provider grievances...+ Review and process member and provider grievances and appeals within federal, state and organizational regulations and policies… more
- Geisinger (Danville, PA)
- Job Summary Provides support in administration of the Appeals and Grievance process. Serves as a liaison between Members and the Plan with appeals regarding ... benefit issues and concerns regarding quality of care or service. PresentsMember appeals to the Plan Medical Staff and Center for Medicare/Medicaid Services… more
- G-TECH Services, Inc. (Detroit, MI)
- Process appeals and grievances, analyze, research, and provide comprehensive responses in accordance with established regulatory and accreditation guidelines. ... Skills/Experience - Optional but preferred skills/experience. Include: * Grievance and Appeals experience. * Degree in Healthcare/computer skills * Experience in… more
- Corewell Health (Grand Rapids, MI)
- Job Summary The Appeals intake coordinator position is focused on the processing of incoming member and provider Medicare appeals and grievances. This team ... member will screen incoming complaints and appeals for level of urgency, benefit or medical necessity...teams as necessary to effectively triage incoming complaints and appeals . Essential Functions + Triaging of incoming appeals… more
- Baylor Scott & White Health (Temple, TX)
- **JOB SUMMARY** The Appeals and Grievance Coordinator is responsible for intake into the Appeals and Grievances Department, including verbal and written ... complaints, grievances and requests for appeals that involve complex matters submitted by Members and...written and fax referred cases from member and provider appeals and complaints for all lines of business, ensuring… more
- Crossroads Hospice & Palliative Care (Green, OH)
- …backgrounds + Problem-solving skills to research and resolve discrepancies, denials, appeals , collections Billing Coordinator Schedule & Benefits: + Schedule: ... we can create lasting impacts that transcend medical treatment. Billing Coordinator Responsibilities: + Obtain referrals and pre-authorizations as required for… more
- Hartford HealthCare (Farmington, CT)
- …tracking and follow-up of requests for information, and timely coordination of appeals and associated deadlines. The Audit Coordinator will also work ... and other common practices across the system. *_Position Summary:_* The Audit Coordinator works under the direct supervision of the Release of Information Manager… more
- Apex Health Solutions (Houston, TX)
- …as part of the preauthorization process; flags cases for review by the Appeals & Outcomes Coordinator Reports potential risk management cases or situations ... as needed for reporting, as maybe delegated by the Quality & Outcomes Coordinator . Adheres to and apply all Health Solutions policies, procedures, and guidelines… more
- University of Utah Health (Salt Lake City, UT)
- …Supervise the day-to-day activities of staff who process member and provider Grievance and Appeals . + Monitor and set goals for staff workloads. + Ensure that staff ... are processing Grievances and Appeals efficiently and in compliance with applicable policies, regulations,...its regulations may be referred to the Title IX Coordinator , to the Department of Education, Office for Civil… more
- City of New York (New York, NY)
- …and drafting correspondence in response to applicant inquiries, concerns, complaints, appeals COMMUNITY COORDINATOR - 56058 Qualifications 1. A baccalaureate ... degree from an accredited college and two years of experience in community work or community centered activities in an area related to the duties described above; or 2. High school graduation or equivalent and six years of experience in community work or… more
- Medical Mutual of Ohio (OH)
- …D experience is highly sought after._** **Responsibilities** **Medicare Pharmacy Coordinator I** Working under general supervision, administers standardized to ... outbound calls to members, providers, and pharmacies to initiate coverage determinations/ appeals , prescription refills, and switch members to lower cost therapeutic… more
- CUNY (New York, NY)
- …action efforts, including the Annual Affirmative Action Plan; + As 504/ADA Coordinator , review appeals of reasonable accommodation request decisions; + ... to improve services; + Conducting fact-finding investigations, including as Title IX coordinator , that ensure due process for all parties in response to complaints… more
- CVS Health (Tallahassee, FL)
- …affordable. **Position Summary** Responsible for intake, investigation and resolution of appeals , complaints and grievances scenarios for all products, which may ... responses from multiple business units. Ensure timely, customer focused response to appeals , complaints and grievance. Identify trends and emerging issues and report… more
- Stony Brook University (East Setauket, NY)
- …follow-up and/or denials appeals and resolution. **Duties of a Revenue Cycle Coordinator may include the following but are not limited to:** + Prepares and ... Revenue Cycle Coordinator **Position Summary** At Stony Brook Medicine the...and complex rejected or denied claims. + Processes complex appeals . + Assists the Supervisor in developing and providing… more
- State of Colorado (Denver, CO)
- Youth Corrections Medical Operations Coordinator (Nurse V) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4573875) Apply Youth Corrections ... Medical Operations Coordinator (Nurse V) Salary $108,540.00 - $151,968.00 Annually Location...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- Access Dubuque (Dubuque, IA)
- Operations Coordinator **Medical Associates** 1 Positions ID: oIchvfwq Posted On 02/06/2025 **Job Overview** **Description** Medical Associates Health Plans is ... hiring an **Operations Coordinator ** to support our Member Services team! This position...being addressed in the mandated time frames such as appeals , audits, etc. + Provide coordination support for day-to-day… more
- Colorado State University (Fort Collins, CO)
- Posting Detail Information Working TitleDevelopment Operations Coordinator , College of Vet Medicine and Biomedical Science Position LocationFort Collins, CO Work ... on02/16/2025 Description of Work Unit Colorado State University Development Operations Coordinator The College of Veterinary Medicine and Biomedical Science's (… more
- University of Colorado (Aurora, CO)
- **Director of Investigations and Deputy Title IX Coordinator ** **Description** **University of Colorado Denver | Anschutz Medical Campus** **Department:** **Office ... of Equity** **Job Title:** **Director of Investigations and Deputy Title IX Coordinator ** **Position #:** **00746937 - Requisition #: 35898** **Job Summary:** as… more
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