- Genmab (Berkeley Heights, NJ)
- …provide a positive experience. This position reports to the Patient Services Manager , Call Center Operations.The creation of our new internal Genmab Patient Services ... verifications, research of prior authorizations and support through the appeals processEvaluate and refer patients to appropriate financial assistance… more
- PharmaCord (Jeffersonville, IN)
- …team immediately at ###@pharmacord.com When you join the team as the Case Manager / Patient Advocate (non-clinical), you'll have the opportunity to make a difference ... requirements, and ensuring their prescriptions or cases are handled timely. The Case Manager / Patient Advocate (non-clinical) role may be eligible for a hybrid… more
- The Crucible (Oakland, CA)
- Job Type Full-time Description Come join The Crucible as our Office Manager for the opportunity to use your expertise in administration, bookkeeping, customer ... arts education nonprofit located in West Oakland! The Office Manager is the lead for ordering materials, equipment, and...fit, what you'd bring to The Crucible and what appeals to you about this position. Due to the… more
- LA Care Health Plan (Los Angeles, CA)
- Registered Nurse (RN) Manager , Appeals and Grievances General Operations (Clinical) Job Category: Clinical Department: CSC Appeals & Grievances Location: Los ... the safety net required to achieve that purpose. Job Summary The Manager , Appeals & Grievances (A&G) & General Operations (Clinical) is responsible for the… more
- Nuvance Health (Danbury, CT)
- *Description* *Summary:* The Manager , Denials Prevention & Appeals Operations is responsible for the direct oversight of daily operations of clinical denial ... This position will work closely with the Denials Prevention & Appeals Administration Manager to guide the development and implementation of new programs and… more
- BronxCare Health System (Bronx, NY)
- …the analysis and preparation of responses to payor denials and develop strong appeals for the purpose of securing reimbursement for acute care services provided to ... identification of patterns and trends identified during the course of appeals preparation. Conduct departmental performance improvement audits, analyze findings and… more
- Catholic Health Services (Melville, NY)
- …services and coordinates utilization/ appeals management review. + Assist Utilization and Appeals Manager in setting up communications with payors and/ or ... facility departments. + Develops/validates daily work lists for Utilization and Appeals Manager . + Assist with all insurance and regulatory audits and provides… more
- Public Storage (Plano, TX)
- …and preferred stocks trade on the New York Stock Exchange. **Job Description** The Senior Manager , Property Tax Appeals and Analysis, is a key member of the ... Public Storage tax team, responsible for strategically managing the property tax appeals process across a national portfolio. This position reports directly to the… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …protected characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Care Manager PreService & Retrospective - Appeals Location: Remote Career Area: ... Health Services About Blue Cross and Blue Shield of Minnesota At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our… more
- New York State Civil Service (Buffalo, NY)
- …imposed by the Workers' Compensation Law* Assist in the assignment of cases when the Appeals Unit Manager is absent for extended periods* Assist the Legal ... Attorney 2/ Assistant Attorney 3 / Senior Attorney - Appeals (NY HELPS) Occupational Category Legal Salary Grade NS...requests* Prepare and timely file clearly written and persuasive appeals , rebuttals, and memos of law with reference to… more
- Molina Healthcare (South Charleston, OH)
- …for leading, organizing and directing the activities of the Grievance and Appeals Unit that is responsible for reviewing and resolving member and provider ... Manages staff responsible for the submission/resolution of member and provider inquiries, appeals and grievances for the Plan. Ensures resolutions are compliant. +… more
- CareFirst (Baltimore, MD)
- …educational and training presentations for internal and external stakeholders. Supports the Manager of Clinical Appeals and Analysis in the development and ... **Resp & Qualifications** **PURPOSE:** The Clinical Appeals Supervisor directs and coordinates the accurate implementation...Licensure Upon Hire Required. + CCM - Certified Case Manager Upon Hire Preferred. + LNCC - Legal Nurse… more
- Mount Sinai Health System (New York, NY)
- …as per department protocol (IPRO Discharge Appeals / Insurance requests) + Support Appeals Nurse / Manager by confirming status of denials + Tracking status ... + Requests or provides Medical Records as required for appeals , On / Off-site Insurance reviews + Implements.../ Off-site Insurance reviews + Implements first step of appeals process to assist Appeals Nurse and… more
- Hawaiian Electric (Honolulu, HI)
- …working on all aspects of litigation matters from case inception to judgment and appeals . Role: Manager Number of Vacancies: 1 Location: Honolulu - Oahu Hiring ... LEGAL Division at Hawaiian Electric Company has 1 Management vacancy available. (Role: Manager ) This posting seeks to fill at either the Associate General Counsel or… more
- Garnet Health (Middletown, NY)
- …for the day to day operation of the CDI department and DRG Denials appeals process. The Manager will develop, implement and evaluate processes, policies and ... Administrator, Coding & Clinical Documentation Improvement and Patient Access, the Manager of Clinical Documentation Integrity (CDI) and DRG Denials is responsible… more
- The County of Los Angeles (Los Angeles, CA)
- …quality assessment and assurance monitoring processes; and handle informal complainant appeals . Health Facilities Program Manager , Nursing positions are required ... HEALTH FACILITIES PROGRAM MANAGER , NURSING Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4626091) Apply HEALTH FACILITIES PROGRAM MANAGER… more
- Elevance Health (Charlotte, NC)
- **Nurse Appeals - Litigation & Legal Support** **Location:** North Carolina, candidates must be residents of North Carolina to be considered. **In Office ... and is dependent on court hearing schedules. The **Nurse Appeals - Litigation & Legal Support** is responsible for...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Elevance Health (Atlanta, GA)
- **Nurse Appeals ** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ... between those hours, including holidays on a rotational basis. The **Nurse Appeals ** is responsible for investigating and processing and medical necessity appeals… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Clinical Appeals Nurse completes research, basic analysis, and evaluation of member and provider disputes regarding ... adverse and adverse coverage decisions. The Clinical Appeals Nurse utilizes clinical skills and knowledge of all...Licensure Upon Hire Required + CCM - Certified Case Manager Upon Hire Preferred + LNCC - Legal Nurse… more
- Beth Israel Lahey Health (Charlestown, MA)
- …difference in people's lives.** This is a remote based role. Reporting to the Manager , Patient Financial Services, the Clinical Analyst plays an important role in a ... high-profile team tasked with handling all commercial and government clinical appeals and audit processes. The Clinical Analyst will perform high-level clinical… more
