- The Cigna Group (Bloomfield, CT)
- …procedures, and policies. + Work with all matrix partners to ensure accurate and timely processing of Medicare Appeals . + Support the implementation of new ... Required. Prefer background as a medical assistant or prior Medicare Claims experience + 3+ years' experience in ...requests for service. + Good knowledge and understanding of Appeals Processing and business/operating processes and procedures.… more
- Banner Health (Tucson, AZ)
- …to employment settings by including remote and hybrid opportunities. In the role of Senior Grievance & Appeals Coordinator, you will utilize your expertise in ... Grievance & Appeals and Medicare to oversee diverse tasks...duty. Coordinates appropriate action by supporting clinical staff for processing of member and provider expedited appeals … more
- Healthfirst (NY)
- …Responsibilities:** + Conduct quality audits of A&G items including grievances, pre-service appeals , and post service appeals utilizing appropriate sources of ... improve processes and performance to ensure quality. + Review and investigate appeals and grievances requests to ensure all requests are identified, classified, and… more
- Medical Mutual of Ohio (OH)
- …any oversight process questions. . Performs other duties as assigned. ** Senior Medicare Pharmacy Coordinator** Working under limited supervision, administers ... mail pharmacy. . Intermediate Microsoft Office skills (Excel, Word, Power Point). ** Senior Medicare Pharmacy Coordinator** . Associate Degree in Business… more
- City and County of San Francisco (San Francisco, CA)
- …the Deputy Director, Patient Financial Services & Patient Accounting, the 0923 Senior Billing Manager is responsible for the successful billing in revenue generated ... the department and analyzes billing regulations and provider updates related to Medicare , Medi-Cal, and other private, government, and other city and county… more
- Highmark Health (Pittsburgh, PA)
- …responsible for the development, implementation, and maintenance of our organization's Medicare Part D formularies and Medicare Pharmacy Programs. ... to federal and CMS requirements. The role requires a deep understanding of Medicare Part D regulations, including the implications of the Inflation Reduction Act,… more
- UNC Health Care (Smithfield, NC)
- …teamwork and reflects UNC Health Care's mission and philosophy. Responsibilities: 1. Appeals & Managed Care Escalations: Project Manage all 3rd party appeals ... Cosmetic & Elective account agreements to ensure accurate postings and processing by carriers. Troubleshoots self-pay payment issues including credit card… more
- Stanford Health Care (Palo Alto, CA)
- …and cash posting of all hospital charges from all payors. The Senior Manager assists the Director in establishing the organizational priorities and operational ... optimal performance of the Hospital Revenue Cycle. The PFS Senior Manager acts as a liaison between PFS operations...variance. Ensures compliance with policies and directives issued by Medicare , Medicaid, Third Party Payers, and others as needed.… more