- Merck & Co. (Rahway, NJ)
- …and other audit-related documents.Assist in the formal process of administrative appeals as necessary.Manage the amendment of state returns resulting from ... conclusions drawn during Federal audits.Required QualificationsBachelor's degree in accounting, finance, or a related field.A minimum of 4+ years in Tax Audit, Tax Compliance, or Tax Accounting.Experience in preparing Federal Forms, particularly Form… more
- AscellaHealth (Berwyn, PA)
- What we are looking for Optime Care seeks a Prior Authorization and Appeals Specialist for our Berwyn, PA location. We are looking for someone who is passionate ... manages the process of receiving, researching, and resolving prior authorizations and appeals issues with health insurance companies, including any escalated step of… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Appeals Specialist II will be responsible for the initial analysis of appeals /grievance correspondence, and ... organizing and tracking information to facilitate and expedite processing of appeals /grievances received from a variety of sources. Responsible for more complicated,… more
- Point32Health (Watertown, MA)
- …(https://www.point32health.org/) . **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Appeals and Grievance Analyst ... the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual works… more
- Molina Healthcare (San Antonio, TX)
- …for leading, organizing and directing the activities of the Grievance and Appeals Unit that is responsible for reviewing and resolving member complaints and ... * Leads, organizes, and directs the activities of the Appeals & Grievances unit that is responsible for reviewing...monitoring and training of local plans' provider dispute and appeals units to ensure adherence with Medicare standards and… more
- Elevance Health (Durham, NC)
- **Manager II Grievance/ Appeals ** **- Claims Support** **Office Locations:** _The selected candidate must reside within a reasonable commuting distance of the ... an accommodation is granted as required by law._ The **Manager II Grievance/ Appeals ** responsible for management oversight of grievances and appeals departmental… more
- Fallon Health (Worcester, MA)
- …on Facebook, Twitter and LinkedIn. **Brief summary or purpose:** Fallon Health (FH) Appeals and Grievance process is an essential function to FH's compliance with ... standards, other applicable regulatory requirements and member expectations. The FH Member Appeals and Grievance Intake Administrator serves to administer the FH … more
- CVS Health (Sacramento, CA)
- …Summary** Responsible for Oversight of that that investigates and resolution of appeals scenarios for all products, which may contain multiple issues and, may ... responses from multiple business units. Ensure timely, customer focused response to appeals . Identify trends and emerging issues and report and recommend solutions.… more
- Molina Healthcare (St. Petersburg, FL)
- …leading, organizing and directing the activities of the Medicare Duals Grievance and Appeals Unit that is responsible for reviewing and resolving member and provider ... complaints, appeals , and claim disputes, and communicating resolution to members,...direct oversight, monitoring and training of provider disputes and appeals to ensure adherence with Medicare standards and requirements… more
- Commonwealth Care Alliance (Boston, MA)
- 011540 CCA- Appeals & Grievances **Position Summary** Appeals and Grievances Specialist supports the Operations Department and the Appeals and Grievances team ... well as externally to facilitate timely resolution of all grievances and appeals and ensures compliance with regulations. Additionally, this position is responsible… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Denials & Appeals Coordinator is responsible for managing, tracking, and resolving denials and appeals to ensure timely reimbursement. This ... trends that can improve claim outcomes. As a Denial Appeals Coordinator at Community Health Systems (CHS) - SSC...current. + Analyzes denials to determine appropriate actions, completes appeals , or routes cases for clinical appeals … more
- CVS Health (Salt Lake City, UT)
- …day. **Position Summary** Responsible for managing to resolution of Fast Track Appeals for Medicare products, which may contain multiple issues and, may require ... issues and report and recommend solutions. Research incoming Medicare Fast Track appeals to identify if appropriate for unit based upon published business… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Appeals Specialist I is responsible for the initial analysis of appeals and/or grievance correspondence, and ... collecting, organizing and tracking information to facilitate and expedite processing of appeals and/or grievances received from a variety of sources. We are looking… more
- State of Colorado (Denver, CO)
- Administrative Assistant II (Criminal Appeals ) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5023135) Apply Administrative Assistant II ... (Criminal Appeals ) Salary $40,036.50 - $50,983.50 Annually Location Denver, CO...for a great administrative professional to join the Criminal Appeals team! This Administrative Assistant II position provides t… 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 ... 2025 Description Job Information Assistant General Counsel III - Appeals , Torts First Date of Posting: 7/10/2025 Last Date...Torts Reports to: Deputy Executive Assistant General Counsel - Appeals Work Location: 130 Livingston St. Brooklyn Hours of… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, ... required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve member… more
- LA Care Health Plan (Los Angeles, CA)
- Manager, Customer Solution Center Appeals and Grievances Job Category: Management/Executive Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, ... to achieve that purpose. Job Summary The Manager, Customer Solution Center Appeals and Grievances is responsible for the centralized intake, logging and triage… more
- Molina Healthcare (Omaha, NE)
- …hours** Must be able to rotate weekends and holidays** Must have Medicare Appeals and IRE experience** **Job Summary** Responsible for reviewing and resolving member ... appeals and communicating resolution to members and provider (or...Responsible for the comprehensive research and resolution of the appeals , dispute, grievances, and/or complaints from Molina members, providers… more
- State of Minnesota (St. Paul, MN)
- **Working Title: Assistant Attorney General - Criminal Appeals Division** **Job Class: Staff Attorney 1, 2, or 3** **Agency: Attorney General's Office** + **Job ID** ... Attorney General-Excluded Oth + **Division/Unit** : Attorney Gen. / Appeals + **Work Shift/Work Hours** : Day Shift +...currently seeking an Assistant Attorney General in the Criminal Appeals division of the Office. This is an exciting… more
- Point32Health (MA)
- …. **Job Summary** Under the general direction of the Manager, Appeals and Grievances the Supervisor, Appeals and Grievances using ... requirements, will coordinate and provide leadership for the daily operations of the Appeals and Grievances department. The supervisor represents the Appeals and… more
