- Stanford Health Care (Palo Alto, CA)
- …accounts; direct the day-to-day activities of insurance claim editing and billing, insurance follow-up, denial and appeals + Serve as a contact/resource to ... Manager serves as a resource to faculty, managers, department and clinic staff in all professional revenue cycle related issues. **Locations** Stanford Health Care… more
- Carnegie Mellon University (Pittsburgh, PA)
- …fund efforts and manage, in collaboration with the Annual Giving team, specific appeals to the international community. + Other duties as assigned. **You should ... of benefits including comprehensive medical, prescription, dental, and vision insurance (https://www.cmu.edu/hr/benefits/health-welfare/index.html)** **as well as a generous retirement savings… more
- Oregon State University (Corvallis, OR)
- …and collaboration. We strive to develop a community of faculty, students, and staff that is inclusive, collaborative, diverse, and centered on student success. COE ... and take them on. We welcome students, faculty and staff from every background and perspective into a community...lifestyle benefits such as pet, accident, and critical illness insurance , giving you peace of mind and the support… more
- BroadPath Healthcare Solutions (Tucson, AZ)
- …Evaluate and route incoming calls and faxes, assigning them to the appropriate staff for further handling + Perform data entry of authorization details into systems ... phone or online before processing authorizations + Assist with complaints and appeals related to eligibility and claims, documenting information accurately in the… more
- Seattle Children's (Seattle, WA)
- …through appropriate internal and external documented channels. + Reconsiderations and appeals are professionally written and tracked efficiently. + Adjustments are ... and timely customer service is provided to payers, patients, families, and staff from other departments and co-workers. + Collaboration with departmental staff… more
- Tutor Perini (Fresno, CA)
- …safety issues or deficiencies. + Oversees and manages on-site Safety Staff , which includes, Safety Coordinators, Safety Apprentices and Safety Administrative ... Supervise and conduct safety and first aid training of staff at the project sites. + Document all accidents,...per established procedures. + Accompany all safety, health, and insurance inspectors on walk through tours. + Prepare written… more
- Tutor Perini (Henderson, NV)
- …safety issues or deficiencies. + Oversee and manages on-site Safety Staff , which includes Safety Engineers, Coordinators, Apprentices and Safety Administrative ... Supervise and conduct safety and first aid training of staff at the project sites. + Document all accidents,...per established procedures. + Accompany all safety, health, and insurance inspectors on walk through tours. + Prepare written… more
- Highland Hospital (Rochester, NY)
- …via telemedicine dependent on clinical availability, personal preference, and insurance guidelines for telemedicine coverage 10-20%Office Practice (Non-Face to Face ... Time) + Assist office nursing and secretarial staff in phone management and triage of patients. +...Complete clinical documentation, forms/paperwork requested by patients, prior authorization appeals , sign home care orders + Coordinate with other… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Insurance Appeals Senior , Revenue Integrity and Utilization Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is ... integrity auditor to take appropriate action. Prepares necessary documentation for insurance appeals process, ensuring timely follow through. Processes claim… more
- BronxCare Health System (Bronx, NY)
- …arrive in letter and electronic format. Collaborating with the Department Denial and Appeals Coordinators, Physician Advisors, and the clinical staff , the Appeal ... Overview The Appeals Manager is responsible to assist in the...patterns and trends to prepare education programs for the staff on identified deficiencies to best respond to all… more
- Mount Sinai Health System (New York, NY)
- …the pre appeals department and related vendors , including supervision of pre appeals nurses, and support staff . + Develop and implement pre appeals ... **Job Description** **Director Pre Appeals Management-HSO Appeals Management -Corporate 42nd...while controlling costs. The Director collaborates closely with medical staff , vendors, case management, and payers to secure payment… more
- AmeriHealth Caritas (Philadelphia, PA)
- …**Leadership and Staff Management** + Supervise daily activities of assigned Appeals & Grievance staff , including scheduling, workload distribution and case ... **Job Summary** As the Supervisor, Appeals and Grievances you will oversee daily operations,...experience leading a team of clinical and non clinical staff + Minimum of 5 years experience in healthcare… more
- Evolent (Springfield, IL)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Specialty Appeals Team offers candidates the opportunity to make a meaningful impact as part of ... a highly trained dedicated team focusing on appeals and post-determination requests. We maintain the principles of...policies and procedures. + Documents communications with medical office staff and/or MD provider as required. + Interfaces with… more
- MTA (Brooklyn, NY)
- Assistant General Counsel III - Appeals , Torts Job ID: 12066 Business Unit: New York City Transit Location: Brooklyn, NY, United States Regular/Temporary: Regular ... Posted: Jul 10, 2025 Description Job Information Assistant General Counsel III - Appeals , Torts First Date of Posting: 7/10/2025 Last Date of Filing: Until Filled… more
- LA Care Health Plan (Los Angeles, CA)
- Lead Customer Solution Center Appeals and Grievances RN Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position ... net required to achieve that purpose. Job Summary The Lead Customer Solution Center Appeals and Grievances RN is responsible for assisting with the development of a… more
- Elevance Health (Indianapolis, IN)
- **Title: Grievance/ Appeals Analyst I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... an accommodation is granted as required by law._ The **Grievance/ Appeals Analyst I** is an entry level position in...approve or summarize and route to nursing and/or medical staff for review. + The grievance and appeal work… more
- Corewell Health (Grand Rapids, MI)
- This position will support our non-contracted provider post claim appeals submitted to the health plan. Job Summary Responsible for the analysis, research and ... all mandated, legislative, regulatory and accreditation requirements. Assist customers and staff throughout the process by providing complete information and follow… more
- St. Luke's University Health Network (Allentown, PA)
- …a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all ... APR-DRG for the purpose of appealing proposed DRG and coding changes by insurance providers or their respective auditors JOB DUTIES AND RESPONSIBILITIES: + Conduct… more
- Ochsner Health (New Orleans, LA)
- …The Appeals Specialist is responsible for managing and resolving insurance claim denials and underpayments to ensure accurate reimbursement. This role involves ... experience with project related, multi-task responsibilities with a professional staff , experience prioritizing, organizing and coordinating multiple work assignments… more
- St. Luke's University Health Network (Allentown, PA)
- …regardless of a patient's ability to pay for health care. The Coding Appeals Specialist analyzes patient medical records, claims data and coding on all diagnosis ... MS-DRG for the purposes of appealing proposed MS-DRG and coding changes by insurance providers or their auditors. Assures that the most accurate and descriptive… more
