- 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
- Sharp HealthCare (San Diego, CA)
- …Status** Regular **Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** Accredited Case Manager (ACM) - American Case Management Association (ACMA); ... Nurse (RN) - CA Board of Registered Nursing; Certified Case Manager (CCM) - Commission for ...in the electronic medical record (EMR) and other supporting case management software.The RN CM II will… 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
- State of Colorado (Morgan County, CO)
- CPW PHY/SCI/RESEARCHER SCIENTIST II / Microbiologist II (Brush, CO) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4798126) Apply CPW ... PHY/SCI/RESEARCHER SCIENTIST II / Microbiologist II (Brush, CO) Salary $74,604.00...(virology, bacteriology, parasitology, and molecular); (d) assist with accessioning case history paperwork, create, develop, or modify forms and… more
- State of Colorado (Denver, CO)
- …about next steps. In a multi-person investigation, this position will often act as the case manager /team leader who is responsible for case file management, ... Consumer Fraud Compliance Investigator II Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4789619) Apply Consumer Fraud Compliance… more
- State of Colorado (Denver, CO)
- ABC's Epidemiologist-Health Professional II - CDB, VPID Program Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4782506) Apply ABC's ... Epidemiologist-Health Professional II - CDB, VPID Program Salary $57,564.00 - $66,198.60 Annually...reviewing reported cases and determining if they meet standard case definitions. + Contribute to chart review and surveillance… more
- LA Care Health Plan (Los Angeles, CA)
- …log and keep track all due dates for each file. Inform nurses of a new case received from Grievance and Appeals Specialist.; submit all Grievances and Appeals ... Authorization Technician II Job Category: Clinical Department: Utilization Management Location:...required by clinical staff to render decisions, assists the Manager and Director of the Utilization Management department in… more
- State of Colorado (Pueblo, CO)
- SOCIAL WORK/COUNSELOR II Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4800337) Apply SOCIAL WORK/COUNSELOR II Salary $73,464.00 - ... and part time Colorado Mental Health Hospital in Pueblo (CMHHIP) Social Work/ Counselor II Full Time As a cornerstone of the Pueblo community for over a century,… more
- Sacramento County (Sacramento, CA)
- Retirement Investment Analyst Level I/ II Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/4169454) Apply Retirement Investment Analyst Level ... I/ II Salary $79,866.00 - $114,255.36 Annually Location Sacramento, CA...investment laws, rules, and regulations. + Effectively evaluate investment manager contracts and investment transactions. + Prepare clear and… more
- WellSpan Health (York, PA)
- Patient Financial Services Representative II - Patient Financial - Day Location: WellSpan Health, York, PA Schedule: Full Time General Summary Completes assigned ... researches claim denial for resolution and submits disputes and appeals . Represents the System in a professional manner while...within 1 year Required or + Certified Patient Accounts Manager within 1 year Required or + Certified Coding… more
- MyFlorida (Fort Lauderdale, FL)
- INVESTIGATION SPECIALIST II Date: Jan 7, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... No: 844124 Agency: Florida Gaming Control Commission Working Title: INVESTIGATION SPECIALIST II Pay Plan: Career Service Position Number: 41500162 Salary: $44,000 -… more
- State of Massachusetts (Boston, MA)
- …to parties in accordance with Massachusetts Employment Security Law. Assist unit manager in the operations of the department. This position requires a combination ... stating the conclusion, and the effect of the determination *3. *Conducts regular case reviews and discussions with staff to develop and enhance their capacity and… more
- Fairfax County Sheriff's Office (Fairfax, VA)
- …Job Announcement Under general direction, this position serves as the Assistant Project Manager for the seven-module Court Case Management System, with a focus ... Business Analyst II Print (https://www.governmentjobs.com/careers/fairfaxcounty/jobs/newprint/4792150) Apply Business Analyst II Salary $73,994.34 -… 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)
- …Clarifying ambiguous or conflicting documentation** **iv. Target DRGs Reviews** **v. Use of case manager as a resource** **4. Uses guidelines to evaluate patient ... functional departments to reduce clinical denials by:** **I. Peer-to Peer (P2P) Concurrent appeals ** ** ii . Written Concurrent appeals ** **iii. Recovery Audit… more
- Hackensack Meridian Health (Hackensack, NJ)
- …d. Clarifying ambiguous or conflicting documentation e. Target DRGs Reviews f. Use of case manager as a resource + 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 Colorado (Denver, CO)
- …the Assistive Technology Training unit supervising Training Specialists IV, III's, and II 's. This position exists to ensure the quality and quantity of ... of rehabilitation staff within the assistive technology work unit. In collaboration with Manager of Blind and Low Vision Services and DVR finance unit, this Position… more
- State of Colorado (Denver, CO)
- …00866 Encumbered By:Paola Torres The incumbent is recommended for reallocation to Health Professional II , C7C2TX Be BOLD Make a REAL difference . . . and join us ... also provides active linkage to high impact behavioral interventions and other case management services. The team frequently interacts with various external medical… more
- State of Massachusetts (Boston, MA)
- …The Executive Assistant will supervise the Docket Clerk in the Hearing and Appeals Unit. *Duties and Responsibilities:*(these duties are a general summary and not ... working in a professional Legal or Government setting as an Office Manager , Paralegal or Executive Assistant or other administrative position. * Superior… more