- PedIM Healthcare (Crystal River, FL)
- …claims to payers promptly. Follow up on unpaid or denied claims and handle appeals as needed. Work with patients to address billing inquiries and provide assistance ... This is NOT a remote position. This position reports to the Billing Manager . The schedule is M-F, 8:30AM-5:00PM. Apply today Apply at www.pedimhealthcare.com (click… more
- BronxCare Health System (Bronx, NY)
- Overview The Appeals Manager is responsible to assist in the analysis and preparation of response to denial notification letters that arrive in letter and ... to best respond to all hospital denials notification and documentation efforts. The Appeals Manager will provide timely tracking and trending of all denials and … more
- Guardian Life (Harrisburg, 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
- LA Care Health Plan (Los Angeles, CA)
- Registered Nurse (RN) Manager , Appeals and Grievances General Operations (Clinical) Job Category: Clinical Department: CSC Appeals & Grievances Location: Los ... the safety net required to achieve that purpose. Job Summary The Manager , Appeals & Grievances (A&G) & General Operations (Clinical) is responsible for the… 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
- Elevance Health (Mason, OH)
- ** Manager II Grievance/ Appeals -RN** **Location** : Ohio-Cincinnati, Columbus, Mason, or Seven Hills ( _Must be within commutable distance to one of the listed ... unless an accommodation is granted as required by law._ The ** Manager II Grievance/ Appeals ** is responsible for management oversight of grievances and appeals… more
- FirstEnergy (Akron, OH)
- …automation or AI where appropriate), strengthen controls and procedures, and handle audits and appeals . The Manager will report to the Director, Tax Planning and ... with FirstEnergy Service Company, a subsidiary of FirstEnergy Corp. The Manager , General Taxes, is responsible for compliance, accounting, forecasting, and planning… more
- Corewell Health (Grand Rapids, MI)
- …all components of insurance prior authorizations, initial reviews, continuous stay reviews and appeals . Nurse Care Manager - Plans and prioritizes care for ... waiting list, insurance prior authorizations, continuous stay reviews and appeals . Additional support to the UM functions of the...Cross Ambulatory Care Management Upon Hire required + Case Manager , Certified (CCM) - CCMC Commission for Case … more
- Hawaiian Electric (Honolulu, HI)
- …working on all aspects of litigation matters from case inception to judgment and appeals . Role: Manager Number of Vacancies: 1 Location: Honolulu - Oahu Hiring ... LEGAL Division at Hawaiian Electric Company has 1 Management vacancy available. (Role: Manager ) This posting seeks to fill at either the Associate General Counsel or… more
- Garnet Health (Middletown, NY)
- …for the day to day operation of the CDI department and DRG Denials appeals process. The Manager will develop, implement and evaluate processes, policies and ... Administrator, Coding & Clinical Documentation Improvement and Patient Access, the Manager of Clinical Documentation Integrity (CDI) and DRG Denials is responsible… more
- The County of Los Angeles (Los Angeles, CA)
- …quality assessment and assurance monitoring processes; and handle informal complainant appeals . Health Facilities Program Manager , Nursing positions are required ... HEALTH FACILITIES PROGRAM MANAGER , NURSING Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4626091) Apply HEALTH FACILITIES PROGRAM MANAGER… more
- Elevance Health (Mason, OH)
- **Nurse Appeals -Licensed Nurse** **Location** : Ohio, candidates must be residents of Ohio to be considered. **Hybrid 1** : This role requires associates to be ... and is dependent on court hearing schedules. The Nurse Appeals is responsible for investigating and processing and medical...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Elevance Health (Cerritos, CA)
- **Title: Grievance/ Appeals Analyst I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... an accommodation is granted as required by law._ 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
- Rush University Medical Center (Chicago, IL)
- …Offers may vary depending on the circumstances of each case. **Summary:** The system manager of denials prevention and appeals , working in a remote environment ... of Epic automation and ancillary coding software solutions. The manager will exemplify the Rush mission, vision and values...Middle Revenue Cycle Audit and denials team members and appeals process, ensuring timely and accurate submission of … more
- Elevance Health (Tampa, FL)
- **Nurse Appeals ** **Hybrid 1:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing ... accommodation is granted as required by law._ The **Nurse Appeals ** is responsible for investigating and processing and medical...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Elevance Health (Columbus, OH)
- **Nurse Appeals RN** **Location** : Ohio-Cincinnati, Columbus, Mason, or Seven Fields _(Must be within commutable distance to the listed locations.)_ **Virtual:** ... accommodation is granted as required by law._ The **Nurse Appeals ** is responsible for investigating and processing and medical...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Elevance Health (Mason, OH)
- **Medical Director-Dermatology Appeals ** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training ... is granted as required by law. The **Medical Director-Dermatology Appeals ** is responsible for the review of appeals...and quality. + Work independently with oversight from immediate manager . + May be responsible for an entire clinical… more
- Elevance Health (Indianapolis, IN)
- ** Appeals Medical Director - Indiana Medicaid** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person ... required by law. Alternate locations may be considered. The ** Appeals Medical Director** is responsible for the appeal reviews...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Elevance Health (Los Angeles, CA)
- **Behavioral Health Medical** **Director-Psychiatrist** ** Appeals ** **Location:** This role enables associates to work virtually full-time, with the exception of ... Director Associates. + Works independently with oversight from immediate manager . + May be responsible for an entire clinical...the United States when conducting utilization review or an appeals consideration and cannot be located on a US… more
- Elevance Health (Tampa, FL)
- …for system edits. + Coordinates research and responds to system inquiries and appeals . + Conducts research of claims systems and system edits to identify ... in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance Health location at least… more
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