- Alameda Health System (Oakland, CA)
- …communication and collaboration with internal departments, external agencies, and insurance providers to facilitate the utilization review process. Participate in ... more
- VNS Health (Manhattan, NY)
- …is an exciting opportunity to: * Lead with Purpose: Manage day-to-day activities for staff handling grievances and appeals across our Managed Long Term Care ... 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
- CareOregon (Portland, OR)
- …records and other documentation. + Work with Quality Assurance clinicians, other CareOregon staff and delegated entities to ensure that appeals and/or grievance ... more
- Fallon Health (Worcester, MA)
- …and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in ... more
- Point32Health (Canton, MA)
- …and communities. **Job Summary** Under the Supervisor's direction, the Member Appeals and Grievances Department Coordinator assists with all operational aspects of ... more
- Catholic Health Services (Melville, NY)
- …advisors and facility departments. | Develops/validates daily work lists for Utilization and Appeals Manager. | Assist with all insurance and regulatory audits ... more
- Legal Aid Society of Mid-New York, Inc. (Utica, NY)
- EXTERNAL JOB POSTING POSITION TITLE Staff Attorney PRACTICE AREA/DEPARTMENT Appeals - Eviction Defense Program OFFICE LOCATION(s) Utica | Binghamton HOURS 35 ... 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
- CVS Health (Phoenix, AZ)
- …meetings when required. * Understands and can respond to Executive complaints and appeals , Department of Insurance , Department of Health or Attorney General ... more
- Point32Health (MA)
- …and mentor staff in the accurate and timely management of Appeals and Grievances providing on-the-spot technical support and direction. + Ensure timely ... more
- CVS Health (Hartford, CT)
- …basis * Provide ongoing education/ subject matter expertise regarding Medicare policy and appeals to the territory Utilization Management staff * Participate in ... more
- New York State Civil Service (Melville, NY)
- NY HELP Yes Agency Insurance Fund, State Title Assistant Attorney 1/ Assistant Attorney 2/ Assistant Attorney 3 / Senior Attorney - Appeals (NY HELPS) ... more
- Centene Corporation (Tallahassee, FL)
- …strongly preferred.** **Position Purpose:** Supervise the day to day operations of the Appeals and Grievance (A&G) staff and functions within the department ... 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** Nonexempt ... more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Senior CBO Appeals Analyst position requires an in-depth knowledge of healthcare pricing/reimbursement processes and procedures including ... 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 report ... more
- Elevance Health (Columbus, OH)
- …enhance quality, efficiency, and training. + Participate in all team meetings, staff meetings, and training sessions. + Assist in mentoring less experienced ... more
- Elevance Health (Columbus, OH)
- …report reopenings. + Under guided supervision, participate in completing more complex appeals related work: + Position papers + Jurisdictional Reviews + Maintaining ... more
- Rush University Medical Center (Chicago, IL)
- …This position reviews initial clinical facility and physician denials, documents appeals for clinical inpatient denials, conducts appeals as appropriate. ... more
