- AscellaHealth (Berwyn, PA)
- What we are looking for Optime Care seeks a Prior Authorization and Appeals Specialist for our Berwyn, PA location. We are looking for someone who is passionate ... more
- CareFirst (Baltimore, MD)
- …**PURPOSE:** This Position will support government programs lines of business. The Appeals Specialist II will be responsible for the initial analysis ... more
- CDPHP (Albany, NY)
- …values and invites you to be a part of that experience. The Clinical Appeals Specialist is responsible for adhering to a member/provider appeal and grievance ... more
- St. Luke's Health System (Twin Falls, ID)
- …great place to work. **What You Can Expect:** Under limited supervision, the Clinical Appeals Specialist 2, is responsible for managing client medical denials by ... more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Appeals Specialist II, under the direction of the Director of Denial Support Services, logs and reviews per documentation guidelines for ... more
- University of Utah (Salt Lake City, UT)
- …Number** PRN41434B **Job Title** Outpatient/Provider Coder Level 3 **Working Title** Medical Appeals & Coding Specialist III **Job Grade** E **FLSA Code** ... more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, ... more
- Baylor Scott & White Health (Temple, TX)
- **JOB SUMMARY** Hybrid position - Temple, TX The Appeals and Grievance Specialist performs reviews, within operational aspects, of the member and provider ... more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Nurse Specialist RN II Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, ... more
- VNS Health (Manhattan, NY)
- OverviewResolves grievances, appeals and external reviews for one of the following VNS Health Plans product lines - Managed Long Term Care (MLTC), Medicare Advantage ... more
- TEKsystems (Sarasota, FL)
- …1. Manages workflow for Humana PPI Audits, RAC Audits, or outpatient appeals and communicates daily with Sr. Director/Manager on trends identified 2. Respond ... more
- University of Michigan (Ann Arbor, MI)
- …Medicine's Hospital Billing Audits & Appeals (HBAA) Department?** The Audit and Appeals Specialist has a strong knowledge of medical appeal and audit ... more
- LA Care Health Plan (Los Angeles, CA)
- Appeals & Grievances Regulatory Audit Readiness Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, ... more
- Lincoln Financial Group (Columbus, OH)
- …you will provide leadership, coaching and development to your team of roughly 8-10 Appeals Specialist , Consultants, and Associates. As an Appeals Manager in ... more
- City of New York (New York, NY)
- …day. In furtherance of this mission, the BXDA seeks experienced and enthusiastic Appeals Specialist (TPA 3) to assist with post-conviction litigation, including ... more
- LA Care Health Plan (Los Angeles, CA)
- …and/or exceed member satisfaction. Responsible for the day to day oversight of Appeals and Grievance Specialist by closely monitoring work, providing feedback on ... more
- Healthfirst (AL)
- …Termination, and Suspension of services. The end to end process requires the Specialist to independently: + Research issues + Reference and understand HFs internal ... more
- CaroMont Health (Gastonia, NC)
- …clinical documentation to determine if an appeal is warranted. Where warranted, the Appeals Specialist will write sound, compelling factual arguments to recoup ... more
- Providence (Renton, WA)
- **Description** The Compliance and Appeals Specialist position manages the USFHP Compliance and Integrity Program under the direction of the USFHP Senior Claims ... more
- The County of Los Angeles (Los Angeles, CA)
- …Accountant I Accountant II Administrative Assistant I Administrative Assistant I, SC Appeals Hearing Specialist Board Specialist Employment Services ... more
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