- Insmed Incorporated (Denver, CO)
- …for patients battling serious and rare diseases. The Field Access Manager will leverage his/her reimbursement expertise and demonstrated experience to identify, ... products as prescribed by the HCP. The Field Access Manager will be a member of the field-based Field...HCP Educate HCP office staff about prior authorization & appeals process, how to access related forms, and high-level… more
- R1 RCM (Boise, ID)
- …sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our **Clinical Appeals and Denials Manager ** , you will serve as an ... denial management. **Here's what you will experience working as a Clinical Appeals & Denials Manager :** + Serve as a leader and mentor to Clinical Appeals… more
- Guardian Life (Bethlehem, PA)
- Guardian is seeking individuals with Group Disability claims experience to join our dynamic Appeals Team. The ** Appeals Case Manager II** (ACM 2) is ... responsible for adjudicating assigned appeals for Group Life and Disability claims. The ACM...Short-Term Disability, Long-Term Disability and Life Waiver of Premium appeals . You are A highly motivated and reliable individual… more
- Elevance Health (KS)
- **Grievance and Appeals Program Manager , Senior** **Location:** Kansas. This position will work a hybrid model (remote and office). The ideal candidate will live ... of one of our Kansas Elevance Health PulsePoint locations. The **Grievance and Appeals Program Manager , Senior** will be responsible for managing Provider… more
- Providence (Anaheim, CA)
- **Description** The Senior Manager Appeals and Grievances has direct responsibility for the design, implementation and ongoing operations of the Health Plan ... position directs and ensures the efficient operational management of health plan appeals and grievances with emphasis on patient and caregiver dignity, outcome… more
- State of Minnesota (St. Paul, MN)
- **Working Title: Senior Manager of Appeals ** **Job Class: State Program Administrator, Manager Senior** **Agency: Department of Employment and Economic ... to deliver this new benefit to Minnesotans. **Position Purpose:** The Senior Manager of Appeals plays a critical role in our organization by providing strategic… more
- BronxCare Health System (Bronx, NY)
- …the analysis and preparation of responses to payor denials and develop strong appeals for the purpose of securing reimbursement for acute care services provided to ... identification of patterns and trends identified during the course of appeals preparation. Conduct departmental performance improvement audits, analyze findings and… more
- Conduent (Hamilton, NJ)
- …and Health Services (DMAHS) of New Jersey. **Reports To** This position reports to the Appeals Supervisor and the Appeals Manager . The Appeals ... individuality is noticed and valued every day. Fair Hearing Appeals Agent $18.50/ Hourly Onsite- Hamilton, NJ Full-time and...were denied coverage, or their coverage was terminated. Our Appeals Counselors process these appeals from applicants… more
- New York State Civil Service (Melville, NY)
- …by the Workers' Compensation Law;* Assisting in the assignment of cases when the Appeals Unit Manager is absent for extended periods;* Assisting the Legal ... Attorney 2/ Assistant Attorney 3 / Senior Attorney - Appeals (NY HELPS) Occupational Category Legal Salary Grade NS...requests;* Preparing and timely filing clearly written and persuasive appeals , rebuttals, and memos of law with reference to… more
- Healthfirst (FL)
- …in collaboration with the Intake Vendor. + Help Standardize and Optimize in how Appeals and Grievances are routed + Work with Providers and DSE on educating ... providers in how to submit Appeals timely and accurately. + Assist in leading the...production, compliance and quality targets and to perform all Appeals & Grievances tasks + Manage, develop and engage… more
- Commonwealth of Pennsylvania (PA)
- …that facilitate the appeals process. You will also communicate with the Appeals Referee Program Manager , UCBR headquarters, and other agency staff and draft ... Appeals Referee Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/4709711) Apply Appeals Referee Salary $75,678.00 - $114,915.00 Annually… more
- Point32Health (MA)
- …here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** Under the general direction of the Senior Manager of Appeals and Grievances the Appeals and Grievance ... and provide leadership for the daily operations of the Appeals and Grievances department. The Supervisor represents the ...team of Analysts and Coordinators + Work with Senior Manager to ensure that employees have the requisite information… more
- VNS Health (Manhattan, NY)
- …to, Provider Relations, Claims, Medical Director, third party administrator, pharmacy benefit manager , to achieve resolution of appeals and grievances. + Ensures ... to day activities for staff handling of grievances and appeals for one of the following VNS Health Plans...subcontractors who have delegated responsibility for managing grievance and appeals on behalf of the plan to ensure operational… more
- State of Minnesota (St. Paul, MN)
- …within the operation, including Claims Adjudication, Contact Center, Payments, Risk, Compliance, and Appeals . The ** Manager of Data and Analytics** will sit on ... **Working Title: Manager of Operational Analytics** **Job Class: State Program... of Operational Analytics** **Job Class: State Program Administrator, Manager ** **Agency: Department of Employment and Economic Development** +… more
- State of Minnesota (St. Paul, MN)
- …the operation, including Claims Adjudication, Contact Center, Payments, Risk, Compliance, and Appeals . The ** Manager of Data and Analytics (this role)** will ... **Working Title: Manager of Data & Analytics** **Job Class: State...of Data & Analytics** **Job Class: State Program Administrator, Manager ** **Agency: Department of Employment and Economic Development** +… more
- Children's Home Healthcare (Richardson, TX)
- …(This is not a remote position) Billing Assistant Essential Functions: + Assist Billing Manager and Appeals Manager with billing operations of agency on ... no claims are filed outside to the timely filing deadlines. + Assist appeals manager with daily appeals and appeal projects. Billing Assistant Financial and… more
- Elevance Health (Meridian, ID)
- **Title: Grievance & Appeals Coordinator** **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 Coordinator** is responsible for investigating and reviewing customer grievances and appeals regarding… 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...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… 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...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… 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...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
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