- CVS Health (Austin, TX)
- …more personal, convenient and affordable. **Position Summary** Prior Authorizations & Appeals Coordinator will be responsible for performing non-clinical ... activities and functions in accordance with policies and procedures, under the supervision of the Clinical Supervisor. Responsible for reviewing and maintaining compliance with ERISA, CMS, Medicaid, and client specific requirements. Works as part of the team… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- Centralized Appeals Unit - Coordinator 1 Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4574630) Centralized Appeals Unit - ... + Description + Benefits Minimum Qualifications Please clickHERE (https://ulsuno.wd1.myworkdayjobs.com/en-US/UniversityOfNewOrleans/job/Baton-Rouge-La/Centralized- Appeals -Unit Coordinator -1-3\_R-001261?q=r-001261) to apply. + Review,… more
- Centene Corporation (Olympia, WA)
- …workplace flexibility. **Position Purpose:** Act as the liaison for all statewide appeals , fair hearings, review organizations, and other external type appeals . ... both State and NCQA requirements. + Review clinical information for all appeals utilizing nationally recognized criteria to determine medical necessity of services… more
- Centene Corporation (Phoenix, AZ)
- …**Position Purpose:** Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members. ... verbal and written member and provider complaints, grievances and appeals + Prepare response letters for member and provider...response letters for member and provider complaints, grievances and appeals + Maintain files on individual appeals … 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 ... **Why This Role is Important to Us:** Appeals and Grievances Representative supports the Operations Department...and Grievances Representative supports the Operations Department and the Appeals and Grievances team in a number of ways… more
- CVS Health (Atlanta, GA)
- …and affordable. **Position Summary** This position supports the daily processing of appeals in the Commercial Member Clinical Appeals (CMCA). Job functions ... faxes, and movement of cases in the Complaints and Appeals Tracking System (CATS). All work is to be...and regulatory standards.This position supports the daily processing of appeals in the Commercial Member Clinical Appeals … more
- CVS Health (Columbus, OH)
- …affordable. **Position Summary** Responsible for intake, investigation and resolution of appeals , complaints and grievances scenarios for all products, which may ... 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 (Los Angeles, CA)
- …use by the examiners or Participant Services Representatives when necessary. * Assist Appeals Coordinator with preparation of Benefits Committee appeal cases. * ... Job Description The Claims Review Coordinator is responsible for the investigation, documentation and...with State/Federal law, rules, and guidelines. The Claims Review Coordinator will perform research and utilize extensive claims knowledge… more
- Crossroads Hospice & Palliative Care (Memphis, TN)
- …backgrounds + Problem-solving skills to research and resolve discrepancies, denials, appeals , collections Medical Billing Coordinator Responsibilities: + Obtain ... we can create lasting impacts that transcend medical treatment. Medical Billing Coordinator Qualifications: + High school diploma required, with 0-1 year of… more
- University of Utah (Salt Lake City, UT)
- …PRN39530B **Job Title** Outpatient/Provider Coder Level 3 **Working Title** Medical Appeals Coding Specialist SR **Job Grade** E **FLSA Code** Nonexempt **Patient ... of revenue cycle. + Working knowledge of insurance denials, appeals and expected reimbursement rates. + Experience presenting findings...its regulations may be referred to the Title IX Coordinator , to the Department of Education, Office for Civil… more
- Medical Mutual of Ohio (OH)
- …**_Eastern & Central Time Zones preferred._** **Responsibilities** **Medicare Pharmacy Coordinator I** Working under general supervision, administers standardized to ... outbound calls to members, providers, and pharmacies to initiate coverage determinations/ appeals , prescription refills, and switch members to lower cost therapeutic… more
- Montana State University (Bozeman, MT)
- …### Classification Title Program Coord II Working Title Customer Experience Coordinator Brief Position Overview MSU Parking and Transportation Services seeks a ... will perform all customer service duties, coordinate the unit's citation appeals process, and provide administrative support. Performs of customer service functions… more
- State of Colorado (Denver, CO)
- CPW ADMINISTRATOR IV / Northeast Region Volunteer Coordinator (Denver, CO) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4666087) Apply CPW ... ADMINISTRATOR IV / Northeast Region Volunteer Coordinator (Denver, CO) Salary $70,140.00 - $91,188.00 Annually Location...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- Colorado State University (Fort Collins, CO)
- Posting Detail Information Working TitleAcademic Success Coordinator Position LocationFort Collins, CO Work LocationPosition qualifies for hybrid/in-office work ... strengthens a diverse, creative and effective community. Position Summary The Academic Success Coordinator ( ASC ) within the Academic Support Center of the College… more
- State of Colorado (Denver, CO)
- Youth Corrections Medical Operations Coordinator (Nurse V) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4573875) Apply Youth Corrections ... Medical Operations Coordinator (Nurse V) Salary $108,540.00 - $151,968.00 Annually Location...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (Durango, CO)
- Equipment Shop Coordinator (Technician IV) - Durango Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4656634) Apply Equipment Shop ... Coordinator (Technician IV) - Durango Salary $54,960.00 - $71,436.00...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- CAU Training - Coordinator 3 Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4653228) CAU Training - Coordinator 3 Salary Depends on ... + Description + Benefits Minimum Qualifications Please clickHERE (https://ulsuno.wd1.myworkdayjobs.com/en-US/UniversityOfNewOrleans/job/Baton-Rouge-La/CAU-Training Coordinator -3\_R-001542-1?q=cau%20training) to apply. + Performs lead role for internal… more
- State of Colorado (Denver, CO)
- Built Environment Coordinator Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4654016) Apply Built Environment Coordinator Salary ... of our programs and practices. The Position The Built Environment Coordinator provides expertise and builds partnerships to advance community-level, public health,… more
- Clark County, NV (Las Vegas, NV)
- TRAINING COORDINATOR Print (https://www.governmentjobs.com/careers/clarkcounty/jobs/newprint/4620142) Apply TRAINING COORDINATOR Salary $32.74 - $50.81 Hourly ... is seeking qualified candidates to apply for the Training Coordinator position. The Training Coordinator , working collaboratively...applicant's response to each item in the assessment, score appeals will not be allowed for this recruitment. +… more
- State of Colorado (Denver, CO)
- ECMC Application Development Coordinator Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4638966) Apply ECMC Application Development ... application. They prioritize projects; liaise with the COGIS Data Coordinator (PHA 117) to communicate any new database needs;...of the department's action. For more information about the appeals process, the official appeal form, and how to… more