- CVS Health (Hartford, CT)
- … appeals team, however the expectation is to cross train for regulated appeals . * Provide support to Medicare appeal nurses * Provide after hours ... more
- Centene Corporation (Phoenix, AZ)
- …individual appeals and grievances + May coordinate the Grievance and Appeals Committee + Support the pay-for-performance programs, including data entry, ... more
- AscellaHealth (Berwyn, PA)
- … Appeals process. + Respond to Prior Authorization denials and submit appeals , collecting appropriate clinical support to substantiate the formal response. + ... more
- VNS Health (Manhattan, NY)
- …tasks, including intake, classification, setup, and assignment of grievances and appeals . Additionally, provides administrative support to staff, including tasks ... more
- R1 RCM (Chicago, IL)
- …analytics, AI, intelligent automation, and workflow orchestration. As our **Clinical Coding Appeals Supervisor** , you will support clinical coders and coding ... more
- HCA Healthcare (Nashville, TN)
- …as we do. We want you to apply! **Job Summary and Qualifications** The Clinical Appeals Analyst is responsible to support the Attorney serving in the role of ... more
- CVS Health (Providence, RI)
- …clinical consistency. Provide after hours and weekend coverage on a rotational basis to support 24/7 appeals work. **Required Qualifications** * Two (2) or more ... more
- Equitable (Charlotte, NC)
- …5 years of experience in the insurance industry, preferably in claims management or appeals . * Prior experience with litigation support or legal knowledge is ... more
- IQVIA (Raleigh, NC)
- …companies for benefit investigation and coverage eligibility + Provide prior authorizations and appeals support + Assist patients with the enrollment process for ... more
- Catholic Health Services (Farmingdale, NY)
- …with internal teams to gather necessary medical documentation and clinical data to support the appeals process. Develop and maintain a system for tracking ... more
- Nuvance Health (Danbury, CT)
- …and operational oversight for a team of utilization review staff, denials and appeals specialists, non-clinical support staff while partnering with local case ... more
- Community Health Systems (Sarasota, FL)
- …defensible appeals + Conducts thorough evidence-based clinical literature research to support appeals , as + needed + Understands and files appropriate levels ... more
- Beth Israel Lahey Health (Burlington, MA)
- …audit tracking system (Cobius) to monitor audit processes, dollars at risk, and appeals . Provide support and training to colleagues.** **Medicare Fraud and Abuse ... more
- AmeriHealth Caritas (Philadelphia, PA)
- …about us at www.amerihealthcaritas.com. **Responsibilities:** Reporting to the Supervisor, Appeals and Grievances, this position is responsible for the ... more
- City of New York (New York, NY)
- …Blueprint for Housing and Homelessness," Mayor Adams' comprehensive housing framework. To support this important work, the administration has committed $5 billion in ... more
- Point32Health (MA)
- …and DNOD's. + Responsible for compliance with all CMS and Livanta timelines. Support the specialists in the completion of appeals and grievances including ... more
- State of Minnesota (St. Paul, MN)
- **Working Title: Appeals Supervisor** **Job Class: Revenue Tax Supervisor 4** **Agency: Revenue Department** + **Job ID** : 84769 + **Location** : St. Paul + ... more
- VNS Health (Manhattan, NY)
- …+ Ensures the accuracy and integrity of data collection and reporting systems to support analysis and reporting of grievances and appeals data for operations and ... more
- UCLA Health (Los Angeles, CA)
- …and internal customers with any issues/questions relating to the complaint, grievance, and appeals process as well as other business support systems. Provides ... more
- LA Care Health Plan (Los Angeles, CA)
- Lead Customer Solution Center Appeals and Grievances Job Category: Administrative, HR, Business Professionals Department: CSC Appeals & Grievances Location: Los ... more