- The Cigna Group (Bloomfield, CT)
- …limited to:** + Ability to differentiate different types of requests Appeals , Grievances, coverage determination and Organization Determinations in order to ensure ... documents, correct appeal types, timeframes and what is being appeals + Assign priority and internal due date based...criteria for reviewing and making decisions on all non-clinical appeals and validating the accuracy of all received information… more
- Commonwealth Care Alliance (Boston, MA)
- …clinical, operations, pharmacy, dental, reporting, and member services. - Supports the Senior Appeals & Grievance Coordinator and A/G Coordinator in day-to-day ... **Why This Role is Important to Us:** Appeals and Grievances Representative supports the Operations Department and the Appeals and Grievances team in a… more
- HUB International (Lafayette, LA)
- …leading success in Mergers and Acquisitions. **Position Summary** The Internal Service Representative addresses all employee benefit issues as brought up by HUB ... providers, and clients to resolve claims (including assistance in the appeals process), enrollment, termination, and billing issues. + Provides knowledgeable answers… more
- Northwell Health (Lake Success, NY)
- …+ Coordinates clinical documentation requests to business office to ensure timely appeals . + Develops and implements policies and procedures to facilitate billing ... and maximize case collections. + Reviews and recommends improvements for financial management of each billing area. + Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with… more
- BrightSpring Health Services (Louisville, KY)
- …Provider issues. Refer all unresolved issues to the next level including grievance and appeals . + Actively market plan to new senior care partners within plan ... Our Company Abode Care Partners Overview Seeking an Account Representative for our Signature Advantage Plan who will work...for our Signature Advantage Plan who will work with senior care partners to assist in enrolling new residents… more
- Exelon (Salisbury, MD)
- …professional and self-starting. **Preferred Qualifications** **PREFERRED QUALIFICATIONS** + Senior representative level experience in energy/utility real ... and sale of property and property rights, property tax assessments and appeals , property management and other real estate related matters. + Assists in… more
- State of Colorado (Denver, CO)
- Senior Legislative Performance Auditor/Analyst I Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4703455) Apply Senior Legislative ... PART OF AN ENTHUSIASTIC, ENERGETIC TEAM THAT IS PASSIONATE ABOUT GOOD GOVERNMENT Senior Legislative Performance Auditor/Analyst If your career goal is to make a… more
- City and County of San Francisco (San Francisco, CA)
- …minimum qualifications. Application Deadline: Continuous How to Apply: Applications for Senior Information Systems Engineer - Systems Specialty are only accepted ... these systems together as an enterprise networking backbone or platform. The 1043 Senior Systems Engineer is the advanced journey level in the Engineer series. The… more
- City and County of San Francisco (San Francisco, CA)
- …minimum qualifications. Application Deadline: Continuous How to Apply: Applications for Senior Information Systems Engineer - Security Specialty are only accepted ... that integrate these systems together as an enterprise networking backbone. The 1043 Senior Security Engineer is the advanced journey level in the Engineer series.… more
- City and County of San Francisco (San Francisco, CA)
- …minimum qualifications. Application Deadline: Continuous How to Apply: Applications for Senior Information Systems Engineer - Networks Specialty are only accepted ... that integrate these systems together as an enterprise networking backbone. The 1043 Senior Networks Engineer is the advanced journey level in the Engineer series.… more
- City and County of San Francisco (San Francisco, CA)
- …qualifications. Application Deadline: Continuous How to Apply: Applications for Senior Information Systems Engineer - Applications Specialty are only accepted ... integrate these systems together as an enterprise networking backbone. The 1043 Senior Applications Engineer is the advanced journey level in the Engineer series.… more
- City and County of San Francisco (San Francisco, CA)
- ….) Recruitment ID: CBT-7365-T000120 / REF44059T Under direction, a Senior Power System Operator is responsible for the daily operation ... Service Commission Rule 409, the duties specified below are representative of the range of duties assigned to this...to change after adoption (eg, as a result of appeals ), as directed by the Director of Transportation or… more
- TAD PGS, Inc. (Chicago, IL)
- …employee grievance and disciplinary matters . + Oversees matters related to the Employee Appeals Board and acts as representative of the Employee Appeals ... Board. + Counsels various departments and offices in labor relations and employment matters such as discipline, layoffs, terminations, transfers, and numerous other matters that may arise between management and employees/unions. + Provides advice and counsel… more
- MyFlorida (Tallahassee, FL)
- SENIOR CONSUMER SERVICE ANALYST - 41000334 Date: Oct 17, 2024 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... . Requisition No: 838841 Agency: Office of the Attorney General Working Title: SENIOR CONSUMER SERVICE ANALYST - 41000334 Pay Plan: Career Service Position Number:… more
- Guardian Life (Bethlehem, PA)
- The ** Senior Life Underwriter** is accountable for managing assigned work, developing agency relationships, and ensuring customer satisfaction at the highest level. ... for the purpose of acquiring necessary information, solving problems, negotiating appeals , and conveying decisions in a polite, confident, and professional manner.… more
- Chesapeake Regional Healthcare (Chesapeake, VA)
- The Senior Coding Specialist is responsible for performing coding tasks required to promote efficient operation of the physician practices within Chesapeake Regional ... practice go lives + Comprehension of payer guidelines for appeals , overpayments, retractions, refunds, eligibility, reconsiderations, referrals, authorizations, payer… more
- State of Colorado (Pueblo, CO)
- …performance and clinical outcomes. This position coordinates and collaborates with senior leadership across the hospital to assess, plan, improve, evaluate and ... meet identified milestones and deadlines. The position notifies appropriate senior leadership and/or managers of any delays, variances or...the official appeal form, signed by you or your representative . This form must be delivered to the State… more
- State of Colorado (Denver, CO)
- …they emerge and addresses them expediently with the Communications Director and senior leadership. + Decides the appropriate subject matter expert to participate in ... releases, and fact sheets, working with the Communications Director, senior leadership, and program staff to provide accurate and...the official appeal form, signed by you or your representative . This form must be delivered to the State… more
- State of Colorado (Grand Junction, CO)
- …residential, intensive outpatient, partial hospitalization and outpatient services. As Senior Authority, this position is responsible for developing policy that ... the Colorado Department of Public Health implement FCBS. This Senior Authority is the sole position to set regulatory...the official appeal form, signed by you or your representative . This form must be delivered to the State… more
- Immigration and Customs Enforcement (Washington, DC)
- …appellate advocacy and motions practice before the Board of Immigration Appeals , the interplay between removal proceedings and extradition, and the interpretation ... the United States. Pursuant to statute, OPLA serves as the exclusive representative of DHS in removal proceedings before the Executive Office for Immigration… more