- CDPHP (Albany, NY)
- …share these values and invites you to be a part of that experience. The Appeals Coordinator is responsible for the timely and accurate triaging all appeals ... necessary information to process their requests within regulatory guidelines. The Appeals Coordinator is also responsible for daily/weekly/monthly department… more
- Kelsey-Seybold Clinic (Pearland, TX)
- …to meet both Corporate and CMS regulatory standards. **Job Title: Appeals & Grievances Coordinator ** **Location: Pearland Administrative Office** **Department:** ... This role actively manages all Medicare reconsiderations, grievances, and appeals , adhering to company policies and CMS regulatory requirements. As… more
- Centene Corporation (Phoenix, AZ)
- …**Position Purpose:** Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members. ... verbal and written member and provider complaints, grievances and appeals + Prepare response letters for member and provider...response letters for member and provider complaints, grievances and appeals + Maintain files on individual appeals … more
- Centene Corporation (Phoenix, AZ)
- …Purpose:** Analyze and resolve verbal and written claims and authorization grievance/ appeals from providers and members. Resolve all State inquires related to ... complaints, grievances and appeals . + Review and process member and provider grievances...+ Review and process member and provider grievances and appeals within federal, state and organizational regulations and policies… more
- G-TECH Services, Inc. (Detroit, MI)
- Process appeals and grievances, analyze, research, and provide comprehensive responses in accordance with established regulatory and accreditation guidelines. ... Skills/Experience - Optional but preferred skills/experience. Include: * Grievance and Appeals experience. * Degree in Healthcare/computer skills * Experience in… more
- ManpowerGroup (Rancho Cucamonga, CA)
- **Title: Temporary Coordinator - Grievance and Appeals ** **Location:** **Rancho Cucamonga California 91730 (Hybrid)** **Schedule: Telecommute (once or twice a ... **Pay Range $20.00 to $23.98/hr.** We are looking for a "Temporary Coordinator - Grievance and Appeals " to join one of our Fortune 500 clients. This is a… more
- CVS Health (Phoenix, AZ)
- …from multiple business units. Ensure timely, customer focused response to complaints/ appeals . Identify trends and emerging issues and report and recommend solutions. ... This position can be anywhere in the United States. **Required Qualifications** 1 year experience that includes both HMO and Traditional claim platforms, products, and benefits, patient management, product, compliance and regulatory analysis, special… more
- Crossroads Hospice & Palliative Care (Green, OH)
- …backgrounds + Problem-solving skills to research and resolve discrepancies, denials, appeals , collections Billing Coordinator Schedule & Benefits: + Schedule: ... we can create lasting impacts that transcend medical treatment. Billing Coordinator Responsibilities: + Obtain referrals and pre-authorizations as required for… more
- UTMB Health (Galveston, TX)
- …+ Demonstrates skill in accurately entering required UM data. Works closely with denials/ appeals coordinator + Elevate to department leadership all patients not ... meeting medical necessity criteria after impasse with attending physician + Creates final patient discharge disposition (closing of cases) Level of Care: + Ensure appropriate level of care/patient status + Facilitate clinical care progression of patient by… more
- Apex Health Solutions (Houston, TX)
- …as part of the preauthorization process; flags cases for review by the Appeals & Outcomes Coordinator Reports potential risk management cases or situations ... as needed for reporting, as maybe delegated by the Quality & Outcomes Coordinator . Adheres to and apply all Health Solutions policies, procedures, and guidelines… more
- State of Colorado (Denver, CO)
- Assistant Attorney General (Criminal Appeals ) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4788540) Apply Assistant Attorney General ... (Criminal Appeals ) Salary $85,795.00 - $132,901.00 Annually Location Denver, CO...this position, please direct your inquiries to our ADAAA Coordinator , Julie Christopher, at ###@coag.govor call ###. If you… more
- Community Health Systems (Fort Smith, AR)
- As a Remote Medical Denials / Appeals Specialist at Community Health Systems - Shared Services Center, you'll play a vital role in supporting our purpose to help ... student loan repayment programs. The Remote Medical Denials / Appeals Specialist position is remote and full time, which...the follow-up teams. (20%) + Works closely with Denial Coordinator , Facility Denial Liaison, and Managed Care Coordinator… more
- Medical Mutual of Ohio (OH)
- …D experience is highly sought after._** **Responsibilities** **Medicare Pharmacy Coordinator I** Working under general supervision, administers standardized to ... outbound calls to members, providers, and pharmacies to initiate coverage determinations/ appeals , prescription refills, and switch members to lower cost therapeutic… more
- CVS Health (Charleston, WV)
- …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
- State of Colorado (Denver, CO)
- Executive Director's Office Coordinator Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4804131) Apply Executive Director's Office ... Office (EDO) welcomes your interest in the Executive Director's Office Coordinator position. This position supports the general administrative needs of the… more
- State of Colorado (Lakewood, CO)
- Special Education Building Coordinator - Mount View YSC in Lakewood, CO Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4771211) Apply Special ... Education Building Coordinator - Mount View YSC in Lakewood, CO Salary...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (Denver, CO)
- Youth Corrections Medical Operations Coordinator (Nurse V) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4573875) Apply Youth Corrections ... Medical Operations Coordinator (Nurse V) Salary $108,540.00 - $151,968.00 Annually Location...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (Denver, CO)
- SNAP E-EBT Coordinator / Social Services Specialist III / H1T3XX Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4789205) Apply SNAP E-EBT ... Coordinator / Social Services Specialist III / H1T3XX Salary...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- University of Colorado (Aurora, CO)
- **Director of Investigations and Deputy Title IX Coordinator ** **Description** **University of Colorado Denver | Anschutz Medical Campus** **Department:** **Office ... of Equity** **Job Title:** **Director of Investigations and Deputy Title IX Coordinator ** **Position #:** **00746937 - Requisition #: 35898** **Job Summary:** as… more
- University of Colorado (Denver, CO)
- **Senior Coordinator for Housing and Dining 3 Vacancies / Openings** **University of Colorado Denver** Senior Coordinator for Housing and Dining [3 Vacancies / ... **Official Title: Student Services Senior Professional** **Working Title: Senior Coordinator for Housing and Dining [3 vacancies]** **FTE: Full-time** **Salary… more