- Ochsner Health (New Orleans, LA)
- …make a difference at Ochsner Health and discover your future today!** The Appeals Specialist is responsible for managing and resolving insurance claim denials and ... **Job Duties** + Review and analyze denied or underpaid claims to determine appeal opportunities. + Prepare and submit...staff and coding teams to obtain necessary documentation for appeals + Track and monitor appeal status, maintaining detailed… more
- Corewell Health (Grand Rapids, MI)
- …to internal departments. Serves as a mentor/trainer to other team members.The Senior Appeals Analyst makes decisions on moderately complex issues regarding ... This position will support our non-contracted provider post claim appeals submitted to the health plan. Job Summary Responsible for the analysis, research and… more
- Rochester Regional Health (Rochester, NY)
- …the payer website, coverage policies and/or phone calls to the payer. Submit corrected claims and appeals . + Process account adjustments and refunds as needed ... accurately managing a receivable. Resolve edits to ensure accurate claims are sent to primary and secondary insurances. Research...and accurately in order to secure payment. As a Senior team member, create and document new processes and… more
- MTA (New York, NY)
- Senior Labor Relations Representative Job ID: 12716 Business Unit: MTA Headquarters Location: New York, NY, United States Regular/Temporary: Regular Department: ... Labor Relations MNR Date Posted: Aug 15, 2025 Description JOB TITLE: Senior Labor Relations Representative DEPT/DIV: Labor Relations WORK LOCATION: 420 Lexington… more
- UNC Health Care (Smithfield, NC)
- …teamwork and reflects UNC Health Care's mission and philosophy. Responsibilities: 1. Appeals & Managed Care Escalations: Project Manage all 3rd party appeals ... ensure proper billing. 10. Other: Responsible for processing Part B split claims . Accurately and thoroughly document the pertinent collection or follow-up activity… more
- State of Colorado (Denver, CO)
- …matters. The Unit manages litigation from inception through hearings and appeals , including fully contested claims , challenges to specific disability ... Senior Paralegal (Legal Assistant II) - Workers' Compensation...Workers' Compensation Division, state agencies, and the State's third party- claims administrator, regarding workers' compensation law, liability exposure, and… more
- City and County of San Francisco (San Francisco, CA)
- …communicate clearly, listen actively, and respond with empathy and professionalism. Senior Eligibility Workers are responsible for carrying out rules and regulations ... Service Commission Rule 109, the duties specified below are representative of the range of duties assigned to this...Training As a condition of employment to 2905 HSA Senior Eligibility Worker position(s), candidates will be required to… more
- Amentum (Washington, DC)
- …Title: Claim Review Assessor Position Description** **AMENTUM Job Title: Senior Paralegal** **MEGA V Labor Category: Paralegal/Legal Assistant II** **General** ... Fund ("VCF") was created to provide compensation for any individual or personal representative of a deceased individual who suffered physical harm or was killed as… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …synthesizes data across multiple domains, including utilization management, prior authorization, claims , denials, and appeals . Their work goes beyond extraction; ... Blue Cross and Blue Shield of Minnesota Position Title: Healthcare Analyst Senior Location: Hybrid | Eagan, Minnesota Career Area: Data Analytics & Business… more
- Manulife (NH)
- …discover that better can take you anywhere you want to go. The Senior Underwriting Consultant is responsible for evaluating applications of the highest financial ... research projects pertaining to risk assessment. + Process formal underwriting appeals and complaints. + Review underwriting fraud referrals for appropriateness and… more
- UNC Health Care (Morrisville, NC)
- …and well-being of the unique communities we serve. **Summary** : The Senior Employee Relations Consultant is responsible for mitigating organizational risk while ... : Investigation and resolution of teammate relations: Maintain a representative caseload involving variety of complex teammate relations issues, including… more
- NJM Insurance (Hammonton, NJ)
- …legal proceedings as appropriate. + Collaborate and communicate cross-departmentally regarding claims and appeals handling related to pending litigation. ... NJM's General Claims Legal department is seeking a PIP Appeal...Job Responsibilities: + Review, evaluate and process incoming Pre-Litigation Appeals in accordance with the PIP Internal Appeal Procedures.… more
- ZOLL Medical Corporation (Pittsburgh, PA)
- …tools and standard operating procedures required to effectively process orders, create claims , manage denials and submit patient appeals . + Consistently ... for improvement initiatives. + Effectively communicates project status and outcomes to senior leadership (verbally and in writing) and serves as an escalation point… more
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