- Point32Health (Canton, MA)
- …and communities. **Job Summary** Under the Supervisor's direction, the Member Appeals and Grievances Department Coordinator assists with all operational ... aspects of the Member Appeals and Member Grievances process for Commercial, TMP and... timely and in compliance with CMS regulations. The coordinator must possess broad understanding of all products and… more
- SANS Institute (Providence, RI)
- …SANS Technology Institute (www.sans.edu) seeks to hire a **Senior Undergraduate Admissions Coordinator ** who will be responsible for the lifeline of the application ... while maintaining an understanding of our graduate programs. This Senior Coordinator will support the applicant journey through interaction with applicants as… more
- Cardinal Health (Providence, RI)
- …. + Follow through on all benefit investigation rejections, including Prior Authorizations, Appeals , etc. All avenues to obtain coverage for the product must be ... fully exhausted. + Track any payer/plan issues and report any changes, updates, or trends to management + Search insurance options and explain various programs to the patient while helping them to select the best coverage option for their situation + Handle… more
- Cardinal Health (Providence, RI)
- …and documenting patient health insurance benefit investigations, prior authorizations, and appeals , preferred (2+ years) + Knowledge of Medicare, Medicaid and ... Commercially insured payer common practices and policies, preferred + Critical and creative thinking, preferred + Knowledge of Medical/Pharmacy billing and coding, preferred + Strong attention to detail is vital + Bilingual, preferred **_What is expected of… more
- Cardinal Health (Providence, RI)
- …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
- Brockton Hospital (Brockton, MA)
- …rounds. Proactively builds post hospital referrals and sends to the Transition Care Coordinator when indicated to facilitate timely discharge. Acts as a change agent ... agencies, to coordinate activities involved in medical record review, denials, appeals and reconsideration hearings. Works closely with the physician advisor to… more