- Guardian Life (Bethlehem, PA)
- …Group Disability claims experience to join our dynamic Appeals Team. The ** Appeals Case Manager II ** (ACM 2) is responsible for adjudicating assigned ... role supports Group Short-Term Disability, Long-Term Disability and Life Waiver of Premium appeals . You are A highly motivated and reliable individual who can work… more
- City of Norfolk, Virginia (Norfolk, VA)
- Assistant Commonwealth Attorney I, II , and III Print (https://www.governmentjobs.com/careers/norfolk/jobs/newprint/2506461) Apply Assistant Commonwealth Attorney ... I, II , and III Salary See Position Description Location Norfolk,...Attorney I: + Prepares cases for trial by reviewing case reports, identifying the relevant facts of the … more
- MyFlorida (Tallahassee, FL)
- INVESTIGATION SPECIALIST II - 41500119 Date: Oct 21, 2024 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... No: 839724 Agency: Florida Gaming Control Commission Working Title: INVESTIGATION SPECIALIST II - 41500119 Pay Plan: Career Service Position Number: 41500119 Salary:… more
- Elevance Health (Roanoke, VA)
- **Nurse Medical Management II ** **Location:** This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 miles of one of our ... Elevance Health PulsePoint locations. The **Nurse Medical Management II ** will be responsible to collaborate with healthcare providers...of care and accurate claims payment. May also manage appeals for services denied. **How you will make an… more
- Tidelands Health (FL)
- …maintain an industry standard clean claim rate. May assistant with writing appeals letters. Assist with training to include team members and physicians. **Position ... by the coding department. + Completes a daily basis case that have been assigned to them utilizing the...coding policies and procedures, and documentation guidelines. + Assists manager with special projects/other tasks as assigned + Safeguards… more
- Elevance Health (Metairie, LA)
- …development, provider partnerships, provider relations, medical management, case management and quality management programs, performance management/improvement, ... budgets, complaints and appeals , regulatory and contractual compliance, monthly financials, and reporting....Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Medical Mutual of Ohio (OH)
- …outbound calls to members, providers, and pharmacies to initiate coverage determinations/ appeals , prescription refills, and switch members to lower cost therapeutic ... with a strong focus on member experience. Conducts outreach to Pharmacy Benefit Manager (PBM) for refills, claim reprocessing and to members to provide status of… more
- Hackensack Meridian Health (Hackensack, NJ)
- …iii. Clarifying ambiguous or conflicting documentation iv. Target DRGs Reviews v. Use of case manager as a resource 4. Uses guidelines to evaluate patient status ... not limited to utilization review, hospital reimbursement, clinical compliance, case management, and transitions of care, as outlined in...clinical denials by: I. Peer-to Peer (P2P) ? Concurrent appeals ii . Written Concurrent appeals … more
- Hackensack Meridian Health (Hackensack, NJ)
- …iii. Clarifying ambiguous or conflicting documentation iv. Target DRGs Reviews v. Use of case manager as a resource 4. Uses guidelines to evaluate patient status ... not limited to utilization review, hospital reimbursement, clinical compliance, case management, and transitions of care, as outlined in...reduce clinical denials by: I. Peer-to Peer (P2P) Concurrent appeals ii . Written Concurrent appeals … more
- State of Montana (Billings, MT)
- …applicable)* *About this Opportunity!* * * *Job Overview:* The Administrative Assistant II is instrumental in ensuring the effective operations of Public Defender ... of Public Defender Offices andreports to the Administrative Support Manager . *Essential Functions (Major Duties or Responsibilities):* *A. *Administrative… more
- Tucson Electric Power (Kingman, AZ)
- …quality of life in the communities we have served for generations, and in TEP's case , since the 1890s. We're building a cleaner, greener grid, with more wind and ... - Right Way of Agent I-III** Position Title: Right of Way Agent, I, II , III, Business Reporting Unit: Land Resources / UNSE Kingman Electric Engineering Reports to:… more
- Nuclear Regulatory Commission (Atlanta, GA)
- …and Policy (HROP), Regional Operations Branch (ROB) and is assigned to the Region II Office in Atlanta, GA. The supervisor is Colleen Todd. This position is ... carrying out HR operations to include responding to grievances, appeals , and other information requests. Participates in labor relations...per pay period. Telework schedules are approved on a case -by- case basis. If selected, telework will be… more
- State of Massachusetts (Boston, MA)
- …with Amusement Device Licensing, Hoisting examinations and Hoisting enforcement and appeals . Administrative and programmatic support includes, but is not limited to: ... building inspectors and providing regular updates to the customers. * Support the manager of the Manufactured Buildings Program required IPS activity. * Confer with… more