- Community Health Systems (Franklin, TN)
- **Job Summary** The Denials & Appeals Coordinator is responsible for managing, tracking, and resolving denials and appeals to ensure timely reimbursement. ... to determine appropriate actions, completes appeals , or routes cases for clinical appeals as needed. + Files and monitors appeals to resolve payer… more
- CVS Health (Sacramento, CA)
- …Summary** Responsible for Oversight of that that investigates and resolution of appeals scenarios for all products, which may contain multiple issues and, may ... responses from multiple business units. Ensure timely, customer focused response to appeals . Identify trends and emerging issues and report and recommend solutions.… more
- Centene Corporation (Indianapolis, IN)
- …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... **Position Purpose:** Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members.… more
- CVS Health (Oklahoma City, OK)
- …day. **Position Summary** Responsible for intake, investigation and resolution of appeals , complaints and grievances scenarios for all products, which may contain ... responses from multiple business units. Ensure timely, customer focused response to appeals , complaints and grievance. Identify trends and emerging issues and report… more
- Insight Global (Nottingham, MD)
- Job Description Day to Day: Insight Global is looking for a Denial Coordinator to support a large hospital system in the Maryland/DC area. This person will be ... overseeing and managing the insurance denial and appeals process to minimize financial risk and improve reimbursement outcomes. Primary Responsibilities: *… more
- Community Health Systems (Antioch, TN)
- **Job Summary** The Denial Coordinator is responsible for reviewing, tracking, and resolving denied claims, ensuring that appropriate appeals are submitted, and ... Hyland, BARRT, and other host systems, ensuring timely follow-up on denials and appeals . + Conducts follow-up calls and payer portal research to track the status… more
- Adelphi University (Garden City, NY)
- …liaison ensuring that candidates experience continuity and support across academic and clinical settings. The Coordinator monitors Manhattan Center RSA CEHS ... NYC Education Program Coordinator Job Department/School College of Education and Health...Teacher Examination and Workshop dates and deadlines. + Oversee clinical practice supervision to ensure candidates receive ongoing support… more
- HCA Healthcare (Manchester, NH)
- …care like family! Jump-start your career as a Medical Staff Services Coordinator today with Catholic Medical Center. **Benefits** Catholic Medical Center, offers a ... Come join our team as a Medical Staff Services Coordinator . We care for our community! Just last year,...play a key role in the integration of HCA Clinical Strategies and HCA systems. 1. Medical Staff Administration… more
- Dartmouth Health (Lebanon, NH)
- …processes for transplant patient testing at outside facilities. Facilitates denial appeals by preparing letters with detailed clinical rationale and ... Overview The Program Leader - Transplant Financial Coordinator is an integral member of the multidisciplinary transplant team with a broad range of responsibilities… more
- System One (Las Vegas, NV)
- Job Title: LTSS Coordinator - Nevada Location: Nevada Type: Contract Compensation: $33/Hour Contractor Work Model: Remote Title: LTSS Coordinator - Nevada ALTA ... Data & Advanced Analytics, and Agile Transformation Services. The LTSS Coordinator - Nevada monitors and promotes effective utilization of long-term services… more
- Cedars-Sinai (Beverly Hills, CA)
- …innovation. **A Little More About What You Will be Doing** The RN Care Coordinator is responsible for the case management of patient while hospitalized and upon ... In collaboration with the Inpatient Specialty Program (ISP) hospitalists, the RN Care Coordinator will assist patients from the time they are admitted until they are… more
- State of Massachusetts (Boston, MA)
- …and child disabilities to fill the role of*Regional Social Security Benefits Coordinator *. Reporting to the Social Security Benefits Manager, the selected candidate ... benefits (eg, Veteran's Benefits, Railroad Benefits, etc.). The Regional Social Security Benefits Coordinator will act as a consultant to Regional and Area DCF staff… more
- Sacramento County (Sacramento, CA)
- Treatment Center Program Coordinator Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/1180508) Apply Treatment Center Program Coordinator ... management with emphasis on health occupations + Principles and techniques of clinical interviewing, diagnosis, and treatment + Most current version of the Diagnosis… more
- US Tech Solutions (RI)
- …with other internal groups regarding determination status and results (seniors, pharmacists, appeals , etc). + Identify and elevate clinical inquiries to the ... + Maintains complete, timely and accurate documentation of reviews. + Transfers all clinical questions, escalations and judgement calls to the pharmacist team. + The… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …additional information, or resolve discrepancies prior to letter release. The UM Denials Coordinator reports to the Clinical Services team and performs a range ... BHPS provides Utilization Review services to its clients. The UM Denials Coordinator supports the Utilization Management function by reviewing denied and partially… more
- Elevance Health (Gary, IN)
- **LTSS Service Coordinator (Case Manager)** **Location:** Seeking candidates located in Lake County Indiana. **_Please note that per our policy on hybrid/virtual ... to client needs, and direct, hands-on engagement. The **LTSS Service Coordinator (Case Manager)** is responsible for conducting service coordination functions for… more
- Rochester Regional Health (Rochester, NY)
- …implements training to ensure compliance with the revenue cycle focusing on clinical documentation, coding, charging, billing, and denial appeals for physicians, ... Full-Time, 40 hours/weekSchedule: Day Shift SUMMARY: The Senior Corporate Compliance Coordinator plays a critical role in minimizing organizational risk by… more
- Elevance Health (Viroqua, WI)
- **LTSS Service Coordinator (Case Manager)** **$5,000 Sign-on Bonus** **Hiring near Southwestern Wisconsin in counties:** Pepin, Buffalo, Trempealeau, Jackson, Clark, ... living, employment, and contributing to their communities. The **LTSS Service Coordinator ** is responsible for conducting service coordination functions for a… more
- Integra Partners (Troy, MI)
- The UM Coordinator assists and supports the clinical team (UM Nurses/Medical Director) with administrative and non- clinical tasks related to processing ... Utilization Management prior authorization sand appeals . JOB RESPONSIBILITIES + Monitor incoming faxes + Enter...expected timelines EXPERIENCE: + 1 year as a UM Coordinator in a managed care payer environment preferred +… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Utilization Review Coordinator ensures efficient and effective management of utilization review processes, including denials and appeals ... activities. This role collaborates with payers, hospital staff, and clinical specialists to secure timely authorizations for hospital admissions and extended stays.… more