- Prime Therapeutics (Frankfort, KY)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Appeals Coordinator **Job Description** + Maintains a caseload and monitors day to ... medical necessity reviews. + Enters all data related to appeals and case reviews into a database. + Prepares...into a database. + Prepares and presents information on appeals to panels second-level multi-disciplinary committee. + Participates in… more
- CVS Health (Frankfort, KY)
- …issues and may require coordination of responses from multiple business units. Appeals are typically more complex and may require outreach and deviation from ... outside plan sponsors or regulators. + Research and resolves incoming electronic appeals as appropriate as a "single-point-of-contact" based on type of appeal. +… more
- CVS Health (Frankfort, KY)
- …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
- Cardinal Health (Frankfort, KY)
- …to Cardinal Health_** The Sr. Coord, Individualized Care (Reimbursement Coordinator ) supports patient access to therapy through Reimbursement Support Services ... * Follow through on all benefit investigation rejections, including Prior Authorizations, Appeals , etc. All avenues to obtain coverage for the product must be… more
- Cardinal Health (Frankfort, KY)
- …documenting patient health insurance benefit investigations, prior authorizations, and appeals , preferred + Knowledge of Medicare, Medicaid and Commercially insured ... payer common practices and policies, preferred + Critical and creative thinking, preferred + Knowledge of the Health Insurance Market Place and the Affordable Care Act preferred + Knowledge of Medical/Pharmacy billing and coding is preferred + Important to… more
- Cardinal Health (Frankfort, KY)
- …Events and follow process for timely submission. Review all requests for appeals and ensure supporting documentation is present. Support team with call overflow ... when needed. Ability to mediate situations in which parties are in disagreement and facilitate a positive outcome. Effectively be able to multitask daily tasks and workload. + **TRAINING AND WORK SCHEDULES** : Your new hire training will take place… more