• Prior Authorization and Appeals

    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
    AscellaHealth (03/13/25)
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  • Appeals Specialist II (Remote)

    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
    CareFirst (02/15/25)
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  • Clinical Appeals Specialist

    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
    CDPHP (03/20/25)
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  • Clinical Appeals Specialist

    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
    St. Luke's Health System (01/08/25)
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  • Clinical Appeals Specialist II…

    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
    Community Health Systems (03/04/25)
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  • Medical Appeals & Coding Specialist

    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
    University of Utah (03/14/25)
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  • Customer Solution Center Appeals

    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
    LA Care Health Plan (03/19/25)
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  • Appeals and Grievance Specialist

    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
    Baylor Scott & White Health (01/28/25)
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  • Customer Solution Center Appeals

    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
    LA Care Health Plan (03/04/25)
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  • Grievance & Appeals Specialist

    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
    VNS Health (02/07/25)
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  • Denials And Appeals Specialist

    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
    TEKsystems (03/06/25)
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  • Utilization Rev Appeals Spec

    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
    University of Michigan (03/21/25)
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  • Appeals & Grievances Regulatory Audit…

    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
    LA Care Health Plan (02/02/25)
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  • STD Appeals Manager

    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
    Lincoln Financial Group (03/13/25)
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  • Appeals Bureau-Trial Preparation Assistant,…

    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
    City of New York (03/06/25)
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  • Lead Customer Solution Center Appeals

    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
    LA Care Health Plan (03/19/25)
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  • Appeals and Grievances Clinical…

    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
    Healthfirst (02/22/25)
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  • Clinical Documentation and Denial…

    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
    CaroMont Health (02/21/25)
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  • Compliance Specialist - USFHP

    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
    Providence (03/20/25)
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  • Administrative Assistant II / Emergency…

    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
    The County of Los Angeles (01/31/25)
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