- LA Care Health Plan (Los Angeles, CA)
- Supervisor , Appeals and Grievances Clinical Operations RN Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 ... the safety net required to achieve that purpose. Job Summary The Supervisor of Appeals and Grievances Clinical Operations (A&G) RN is responsible for executing… more
- RWJBarnabas Health (Oceanport, NJ)
- Supervisor , Appeals , Remote, NJReq #:0000176996 Category:No Category Assigned Status:Full-Time Shift:Day Facility:RWJBarnabas Health Corporate Services ... Department: Appeals Location: Remote, 2 Crescent Place, Oceanport, NJ 07757...2 Crescent Place, Oceanport, NJ 07757 Job Overview: The Supervisor is responsible for managing technical and clinical denials… more
- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Supervisor , Grievances & Appeals is an inventory based role, supporting a team of ... resolutions. This position will also support quality related go The Supervisor , Grievances & Appeals is an inventory based role, supporting a team of associates… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Clinical Appeals Supervisor (RN) directs and coordinates the accurate implementation of the clinical appeal process ... the activities and serves as a resource for associates within the Clinical Appeals and Analysis unit supporting Government Programs lines of business. We are looking… more
- Glens Falls Hospital (Glens Falls, NY)
- …**Job:** **Allied Health - Health Information Management* **Title:** *Coding Reimbursement Appeals Supervisor - Health Information Management (HIM) * ... **Location:** *NY-Glens Falls* **Requisition ID:** *2203X* more
- Medical Mutual of Ohio (Brooklyn, OH)
- …. Conducts regular and ongoing coaching to drive the highest level of team performance and ensure an optimal customer experience. Ensures adherence to goals (eg ... customer satisfaction percentages, compliance, call metrics, inventory volumes and established service levels, productivity, quality assurance). Reviews holistic performance with CCSs, identifies developmental needs and takes steps to assist staff to achieve… more
- Conduent (Hamilton, NJ)
- …and Health Services (DMAHS) of New Jersey. **Reports To** This position reports to the Appeals Supervisor and the Appeals Manager. The Appeals Manager ... individuality is noticed and valued every day. Fair Hearing Appeals Agent $18.50/ Hourly Onsite- Hamilton, NJ Full-time and...were denied coverage, or their coverage was terminated. Our Appeals Counselors process these appeals from applicants… more
- UCLA Health (Los Angeles, CA)
- …grievances, in accordance with state and federal regulations. + Assisting the unit Supervisor in overseeing the appeals and grievances process, ensuring that ... Description As the Senior Appeals and Grievances Analyst, you will be responsible...requirements. + Collaborating with other organizational stakeholders, including other Appeals & Grievances team members, additional business units within… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- OAAS LT-PCS Appeals - Coordinator 1 Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4677715) OAAS LT-PCS Appeals - Coordinator 1 Salary ... + Description + Benefits Minimum Qualifications Please clickHERE (https://ulsuno.wd1.myworkdayjobs.com/en-US/UniversityOfNewOrleans/job/Baton-Rouge-La/OAAS-LT-PCS- Appeals Coordinator-1\_R-001522-1?q=oaas) to apply. + Receive appeal notices… more
- LA Care Health Plan (Los Angeles, CA)
- Lead Customer Solution Center Appeals and Grievances Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 ... to achieve that purpose. Job Summary The Lead of Customer Solution Center Appeals and Grievances is responsible for assisting with the development of a successful… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, ... required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve member… more
- Health First (Melbourne, FL)
- …in the State of Florida* *POSITION SUMMARY* Manage the formal complaints and appeals process in a timely, professional and compliant manner, to include formal member ... resolve internal operational issues that may cause increase to member appeals /grievances volumes and drive operational efficiencies. 10. Maintain technical knowledge… more
- Alameda Health System (San Leandro, CA)
- Care Management Clinical Appeals Specialist + San Leandro, CA + Finance + Patient Financial Svcs - Facil + Full Time - Day + Business Professional & IT + Req ... executes the appeal process for all AHS facilities clinical appeals and third party audits. **DUTIES & ESSENTIAL JOB...Initiates the appeal process, at the direction of the Supervisor and/or physician advisors, until the case is overturned,… more
- Generac Power Systems (Waukesha, WI)
- …solutions company, we continue to push new boundaries. **Job Description:** The ** Appeals and Grievances Coordinator** is a critical team player who is responsible ... under general supervision with some guidance from leadership and higher-level Appeals and Grievances Specialists. **Job Responsibilities:** + Perform a variety of… more
- Mount Sinai Health System (New York, NY)
- …for one or more individuals, a department or a division. Assists supervisor in routine personnel, budget and other operational details. This individual typically ... 2-3 years administrative or medical office experience required , 416 - HSO Appeals Management - MSH, Mount Sinai Hospital **Responsibilities** 1. Serves as an… more
- Guidehouse (Birmingham, AL)
- …Companies to resolve claim denials and account balances. + Performing Non-Clinical Appeals . + Assisting Supervisor /Manager as needed with various projects. + ... Escalate payer issues/trends to a supervisor with the appropriate information or take appropriate action...+ 0-2 years medical provider experience working with UB04, appeals & denials. **What Would Be Nice to Have**… more
- Louisiana Department of State Civil Service (Houma, LA)
- …agency administrators and assure program compliance with contract expectations. + Prepare appeals packets for supervisor review and approval for program ... WORK: Experienced. SUPERVISION RECEIVED: General from a Community Services Supervisor , a higher-level professional or an administrator. SUPERVISION EXERCISED: None… more
- City and County of San Francisco (San Francisco, CA)
- …looks like in action. Under general direction, the Medical Social Work Supervisor works for the Department Disability and Aging Services Hub. This position ... 2940 Protective Services Worker staff. Along with supervision, this supervisor provides consultation concerning the most difficult cases and...to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or… more
- State of Colorado (CO)
- CDOC Food Service Supervisor CSTS I - 7/2024 Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4563628) Apply CDOC Food Service Supervisor ... CO Job Type Full Time Job Number CAA FS Supervisor CSTS I 7/24 Department Department of Corrections Opening...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- City and County of San Francisco (San Francisco, CA)
- …examination process is subject to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or the Civil Service Commission. ... Rule 111A.35.1. The standard for the review of such appeals is 'abuse of discretion' or 'no rational basis'...position description, the minimum qualifications and/or the certification rule. Appeals must include a written statement of the item(s)… more
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