- Mount Sinai Health System (New York, NY)
- **Job Description** This position serves as Appeals Analyst for Central Billing Office management. Responsible for monitoring contractual allowances, analyzing ... and pursuing appeals opportunities with payors and networks, and reporting performance...network offices. 8. Prepares Adhoc payor performance metrics detailing appeals and recoveries. 9. Monitors, tracks, and corrects registration… more
- TEKsystems (Annapolis, MD)
- Hybrid Coding Appeals Analyst Opportunity to join one of Maryland's most renowned and established healthcare systems. This organization is committed to ... Schedule : Monday - Friday (Normal Business Hours) Position Summary: As a Coding Appeals Specialist, you will be a crucial member of the denial management team by… more
- Point32Health (TX)
- …general direction of the Member Appeals and Grievance Supervisor the Member Appeals and Grievance Analyst is responsible per State and Federal regulations ... the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual works… more
- RWJBarnabas Health (Oceanport, NJ)
- Associate Analyst ARS, Appeals , Remote, NJReq #:0000175741 Category:No Category Assigned Status:Full-Time Shift:Day Facility:RWJBarnabas Health Corporate ... Place, Oceanport, NJ 07757 Summary of Job Function The Associate Analyst , Appeals is primarily responsible for validating clinical and technical denials to… more
- Highmark Health (Columbus, OH)
- …of a grievance/appeal; documents, investigates, refers and coordinates grievances and appeals ; initiates a case file for each grievance and appeal; ensures ... all involved parties. + Participate in workgroup meetings to address trends in appeals and grievances and to work on process improvement initiatives with cross… more
- Henry Ford Health System (Troy, MI)
- …for the prompt and thorough investigation of medical and pharmacy member appeals and grievances for Health Alliance Plan's (HAP's): Commercial, Medicare Advantage, ... Medicare-Medicaid Program (MMP), and Medicaid lines of business. Analyst must identify trending issues on an ongoing basis and provide root/cause analysis when… more
- CVS Health (Columbus, OH)
- …**Required Qualifications** Compliance experience Audit Experience Grievance and Appeals Experience **Preferred Qualifications** **Education** High School Diploma or ... GED **Pay Range** The typical pay range for this role is: $21.10 - $36.78 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will… more
- Molina Healthcare (WI)
- …and documents Medicaid and Medicare Advantage denial determinations for reconsiderations/ appeals in a thorough, professional and expedient manner. May include ... + Reviews, classifies, researches, and resolves member complaints (grievances and/or appeals ) and communicates resolution in writing to members and providers or… more
- Point32Health (Canton, MA)
- …be doing** + Assign new verbal and written appeals and grievances to Appeals and Grievances Analyst + Process Fast Track Appeals including monitoring ... Management, and Independent Review Organization (IRO) + Support A&G Analyst in timely completion of Appeals and...Support A&G Analyst in timely completion of Appeals and Grievances + Adheres to all regulatory and… more
- City and County of San Francisco (San Francisco, CA)
- …and County of San Francisco has to offer. As a Senior Administrative Analyst , you will be responsible for directing and performing challenging, complex, and ... operations. + Providing a real-world example, a Senior Contracts Analyst could assist with procurement and contract administration related...to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or… more
- City and County of San Francisco (San Francisco, CA)
- …that may impact the department. + Providing a real-world example, a Junior Policy Analyst for the Office of the Treasurer & Tax Collector could involve working to ... partners. + Providing a real-world example, a Junior Budget Analyst may have the opportunity to learn about the...to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or… more
- City and County of San Francisco (San Francisco, CA)
- …grants, contracts, budgets, finance, and/or program evaluation and planning. As an Administrative Analyst , you may work with a manager to perform research to develop ... the department. + Providing a real-world example, a Policy Analyst for the Office of the Treasurer & Tax...to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or… more
- State of Colorado (Denver, CO)
- Systems Analyst ( Analyst III) - Denver Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4775922) Apply Systems Analyst ( Analyst ... months. #LI-POST Description of Job About the Unit This Analyst IIII position works in the Colorado Department of...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)
- …years of verifiable professional human resources experience, similar to 1241 Human Resources Analyst , in one or more of the following areas of activity: recruitment ... Additional qualifying work experience as a professional human resources analyst may be substituted for up to two years...to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or… more
- State of Colorado (CO)
- SDoH Health Information Exchange (HIE) Business Analyst Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4779140) Apply SDoH Health Information ... Exchange (HIE) Business Analyst Salary $70,140.00 - $91,188.00 Annually Location Statewide, CO...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)
- …County of San Francisco has to offer. In the role of Principal Administrative Analyst , you will lead and perform challenging and complex projects that span areas ... in this selection process, which includes the following: Administrative Analyst Core Exam (Weight: 60%) Candidates meeting the Minimum...to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or… more
- University of Michigan (Ann Arbor, MI)
- HEALTH INFORMATION MANAGEMENT ANALYST II - COMPLIANCE AND AUDITING Apply Now **Job Summary** Utilize the EPIC Release Module to locate, analyze, and produce medical ... General Counsel + Perform medical record release tracking related to audits and appeals activity in the MiChart Audit and/or MiChart Release of Information modules… more
- CVS Health (Springfield, IL)
- …care more personal, convenient and affordable. **Position Summary** As a Senior Analyst , Business Analytics within the Pricing Operations organization, you will be ... supporting pricing and appeals reporting for Caremark clients. In this role you...be responsible to generate standard and customized pricing and appeals reporting in order to meet deadlines driven and… more
- Staffing Solutions Organization (Albany, NY)
- …a reflection of our clients and the people they serve. **Business Requirements Analyst ** **- Albany, NY** **DEMI - 1023** **Summary** Within the Division of ... the new eligibility system for New York's Complex Medicaid population, and the new appeals management system. The individual will act as a liaison between the DEMI… more
- CommonSpirit Health (Englewood, CO)
- …our hospitals and out in the community. **Responsibilities** The **Senior Reimbursement Analyst i** s responsible for providing cost report preparation, cost report ... appeals , audit preparation and other duties related to the...and other State and Federal regulations. The Sr. Reimbursement Analyst interacts with customers and ensures value is delivered… more