- 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
- CVS Health (Indianapolis, IN)
- …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
- Munson Healthcare (Traverse City, MI)
- …experience in a revenue cycle role (billing, registration, insurance verification, referral coordinator , etc) . Ability to work independently and problem solve with ... of Utilization Management and works closely with the Utilization Management and Appeals team . Interacts independently with all Munson Health Care departments.… 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 (Salem, OR)
- …workplace flexibility. **Position Purpose:** Act as the liaison for all statewide appeals , fair hearings, review organizations, and other external type appeals . ... NCQA requirements. **(PST preferred).** + Review clinical information for all appeals utilizing nationally recognized criteria to determine medical necessity of… 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
- Geisinger (Danville, PA)
- Job Summary Provides support in administration of the Appeals and Grievance process. Serves as a liaison between Members and the Plan with appeals regarding ... benefit issues and concerns regarding quality of care or service. PresentsMember appeals to the Plan Medical Staff and Center for Medicare/Medicaid Services… more
- Robert Half Accountemps (Los Angeles, CA)
- …guidelines for use by examiners or Participant Services Representatives. * Assist Appeals Coordinator with the preparation of Benefits Committee appeal cases. ... is in the immediate need of a Grievance & Appeals Specialist. The Grievance & Appeals Specialist,...2 years of experience as a Medical Claims Review Coordinator or in a similar role * Proficient in… more
- Commonwealth Care Alliance (Boston, MA)
- …clinical, operations, pharmacy, dental, reporting, and member services. + Supports the Senior Appeals & Grievance Coordinator and A/G Coordinator in ... 011540 CCA- Appeals & Grievances **Position Summary** Appeals and Grievances Specialist supports the Operations Department and the Appeals and Grievances team… 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...3 administrative professionals, a paralegal, and a victim services coordinator . The team is responsible for defending criminal convictions… more
- CUNY (New York, NY)
- …action efforts, including the Annual Affirmative Action Plan; + As 504/ADA Coordinator , review appeals of reasonable accommodation request decisions; + ... to improve services; + Conducting fact-finding investigations, including as Title IX coordinator , that ensure due process for all parties in response to complaints… more
- City of New York (New York, NY)
- …and Article 78 requests and simultaneously handle post-conviction litigation, including direct appeals , Article 440 motions, and federal writs of habeas corpus. JOB ... made through Office internal request system Make recommendations to Appeals Bureau Chief on viability of such appeals... Appeals Bureau Chief on viability of such appeals and communicate with other bureaus about requests Draft… more
- Montana State University (Bozeman, MT)
- …Classification Title Program Coord II Working Title Customer Experience Coordinator Brief Position Overview MSU Parking and Transportation Services seeks ... will perform all customer service duties, coordinate the unit's citation appeals process, and provide administrative support. Performs of customer service functions… more
- Iowa Department of Administrative Services (State Of Iowa, IA)
- Program Coordinator - Adult & Special Services Print (https://www.governmentjobs.com/careers/iowa/jobs/newprint/5024760) Apply Program Coordinator - Adult & ... IA Job Type Full-time Job Number 26-00249 Agency 427 Department of Inspections, Appeals & Licensing Opening Date 07/29/2025 Closing Date 8/12/2025 11:59 PM Central… more
- Elderwood (Cheektowaga, NY)
- Salary $18.50 - $23.07/Hour Overview Managed Care Coordinator Overview The Managed Care Coordinator assists and supports the LPN/RN MDS Coordinator with case ... updates as requested by Insurance Companies, handles Third Party appeals , peer to peers as applicable and with clinical...and with clinical oversight provided by the LPN/RN MDS Coordinator . Attends team meetings at the discretion of the… more
- State of Colorado (Garfield County, CO)
- DWR - Augmentation Plan Coordinator & Technician (EPST I) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5026651) Apply DWR - Augmentation ... Plan Coordinator & Technician (EPST I) Salary $5,218.00 - $7,708.00...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (CO)
- Project Coordinator Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5020762) Apply Project Coordinator Salary $58,872.00 - $76,536.00 ... https://www.colorado.gov/pacific/dhr/student-loan-forgiveness-programs . https://dhr.colorado.gov/dhr-resources/student-loan-forgiveness-programs We are looking for a Project Coordinator for the Enterprise Project Management Office (EPMO) of… more
- Clark County, NV (Las Vegas, NV)
- DEPARTMENTAL SYSTEMS COORDINATOR Print (https://www.governmentjobs.com/careers/clarkcounty/jobs/newprint/5006413) Apply DEPARTMENTAL SYSTEMS COORDINATOR Salary ... is seeking qualified candidates to apply for the Departmental Systems Coordinator position. This position is responsible for administering the department's computer… more
- State of Colorado (Denver, CO)
- TERM-LIMITED: Project Coordinator (Sexual Assault Evidence Review Board) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5006572) Apply ... TERM-LIMITED: Project Coordinator (Sexual Assault Evidence Review Board) Salary $58,872.00 -...of the department's action. For more information about the appeals process, the official appeal form, and how to… more