- Apex Health Solutions (Houston, TX)
- Summary: The Appeals and Grievances coordinator, Senior position, is focused on the processing of customer and provider Medicare and Commercial appeals and ... and a commitment to the Continuous Quality Improvement Process. The Appeals & Grievance Coordinator, Senior , will interact on a daily basis with the Customer… more
- UCLA Health (Los Angeles, CA)
- Description As the Senior Appeals and Grievances Analyst, you will be responsible for: + Assisting with all operational aspects of appeals and grievances, in ... state and federal regulations. + Assisting the unit Supervisor in overseeing the appeals and grievances process, ensuring that members and providers receive fair and… more
- Elevance Health (Columbus, OH)
- **Audit & Reimbursement Senior - Appeals ** _This is a United States based, virtual position._ **National Government Services** is a proud member of Elevance ... Services to transform federal health programs. The **Audit and Reimbursement Senior - Appeals ** will support our Medicare Administrative Contract (MAC) with… more
- New York State Civil Service (New York, NY)
- …Fund, State Title Assistant Attorney 1/Assistant Attorney 2/ Assistant Attorney 3 / Senior Attorney - Appeals (NY HELPS) Occupational Category Legal Salary Grade ... Bar and 12 months of subsequent satisfactory legal experience*For appointment to Senior Attorney (Grade 25):* Reachable on current Civil Service eligible list for… more
- Commonwealth Care Alliance (Boston, MA)
- …clinical, operations, pharmacy, dental, reporting, and member services. * Supports the Senior Appeals & Grievance Coordinator and A/G Coordinator in day-to-day ... CCA- Appeals & Grievances Processing of Grievances & Appeals : * Responsible for the progress of grievance and appeal intervention and resolution. * Assure verbal… 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 ... and concerns regarding quality of care or service. PresentsMember appeals to the Plan Medical Staff and Center for...dental and domestic partners. Perhaps just as important, from senior management on down, we encourage an atmosphere of… more
- NJM Insurance (Hammonton, NJ)
- NJM's General Claims Legal Department is currently seeking to fill a PIP Appeals and Litigation (PAL) Representative position. We are looking for talent who has ... Duties and Responsibilities:* Review, evaluate and process incoming Pre-Litigation Appeals in accordance with the PIP Internal Appeal Procedures*...role may be filled at a Level I or Senior level based on skills, experience and credentials. Legal… more
- Health First (Melbourne, FL)
- …in the State of Florida* *POSITION SUMMARY* Manage the formal complaints and appeals process in a timely, professional and compliant manner, to include formal member ... oversee routine audits to ensure quality and compliance. 5. Elevate issues to senior management as necessary to minimize legal risks. 6. Identify opportunities for… more
- Healthfirst (AZ)
- …is Remote + Conduct quality audits of A&G items including grievances, pre-service appeals , and post service appeals utilizing appropriate sources of information; ... improve processes and performance to ensure quality. + Review and investigate appeals and grievances requests to ensure all requests are identified, classified, and… more
- Health First (Rockledge, FL)
- …a professional image to the public. *Stewardship: * * Elevating issues to senior management as necessary to minimize financial risks. * Reporting trends to help ... Plan Inc* **Title:** *HFHP Appeal /Grievance Coordinator - Member Appeals Grievances* **Location:** *Florida - Brevard County-Rockledge* **Requisition ID:** *075564* more
- Walmart (Bentonville, AR)
- …Specialist with subject matter expertise in gig driver deactivations, strikes, appeals , reactivations, and pre-arbitration. As a Trust & Safety Specialist, you ... trends, issues, and challenges related to gig driver deactivations, strikes, appeals , reactivations, and pre-arbitration. - Serve as the company's primary point… more
- City and County of San Francisco (San Francisco, CA)
- …volume and consistent pressure while fighting fires. The division is looking for Senior IS Business Analysts that work effectively with a wide range of operations ... to change after adoption (eg as a result of appeals ), as directed by the Human Resources Director or...Rule 111A.35.1. The standard for the review of such appeals is 'abuse of discretion' or 'no rational basis'… more
- City and County of San Francisco (San Francisco, CA)
- …a lasting impact on people's lives and City services. Job Description Senior Performance Analysts work with Project Managers and departmental partners to improve ... to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or...Rule 111A.35.1. The standard for the review of such appeals is 'abuse of discretion' or 'no rational basis'… more
- MyFlorida (Tallahassee, FL)
- SENIOR ATTORNEY - 61000184 Date: Nov 16, 2024...Florida Public Service Commission hires will work in the Appeals , Rules and Ethics Section of the Office of ... Requisition No: 837821 Agency: Public Service Commission Working Title: SENIOR ATTORNEY - 61000184 Pay Plan: SES Position Number:...of combined experience in these areas is ideal. Commission appeals are generally before the First District Court of… more
- Animal Care Centers of NYC (New York, NY)
- Senior Manager, Individual Giving Who We Are ACC is one of the nation's largest open-admission animal shelters whose mission is to End Animal Homelessness in NYC. We ... of New York City. Summary ACC is seeking a Senior Manager, Individual Giving who will play a key...and digital campaigns, segmenting donor lists, and executing targeted appeals , with an immediate emphasis on targeted appeals… more
- City and County of San Francisco (San Francisco, CA)
- …City and County of San Francisco is looking to bring on board multiple Senior Human Resources Analysts to help departments in hiring, supporting, and retaining a ... City and County of San Francisco has to offer. Senior Human Resources Analysts are responsible for hiring, developing,...to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or… more
- R1 RCM (Salt Lake City, UT)
- …analytics, AI, intelligent automation, and workflow orchestration. As our Denials and AR Senior Analyst, you will help R1 by managing assigned accounts or clients. ... insurance companies to resolve authorization and claim denials, write appeals and letters to insurance companies to resolve denials,...you will experience working as a Denials & AR Senior Analyst:** + You will be investigating and analyzing… more
- City of Norfolk, Virginia (Norfolk, VA)
- Senior Assistant Commonwealth's Attorney Print (https://www.governmentjobs.com/careers/norfolk/jobs/newprint/4665232) Apply Senior Assistant Commonwealth's ... + Questions Description Norfolk Commonwealth's Attorney Ramin Fatehi seeks one Senior Assistant Commonwealth's Attorney. This position is required to perform duties… more
- New York State Civil Service (Albany, NY)
- NY HELP Yes Agency Education Department, State Title Senior Attorney, Assistant Attorney 1 (NY HELPS) Box OHE-1240/14724 Occupational Category Legal Salary Grade 25 ... Admission to the NYS Bar AND 12 months of subsequent satisfactory Legal experience.* Senior Attorney: 12 months as an Assistant Attorney 3, OR Admission to the NYS… more
- Kalmar Solutions (IN)
- Category: Kalmar Facility: Finance Location: Navi Mumbai, MH, IN Senior Manager Taxation Kalmar is moving goods in critical supply chains around the world, with the ... Direct Tax Notice Processing (all types), Income Tax Assessments, Appeals and Litigations , Filing of Rectification Petition and...Petition and handling of old pending tax assessment and appeals . * Apply and follow-up Income Tax Refunds (B)… more
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