- Martin's Point Health Care (Portland, ME)
- …certified as a "Great Place to Work" since 2015. Position Summary The Appeals Quality and Training Specialist supports the Appeals Department. This ... role supports Appeals quality goals through quality monitoring and training . This role partners directly with Appeals leadership to support on-going… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Quality Auditing Specialist II Job Category: Administrative, HR, Business Professionals Department: CSC ... The Customer Solution Center Appeals and Grievances Quality Auditing (QA) Specialist II is responsible...is responsible for assisting the Appeal and Grievances Compliance, Training and QA Manager to develop a successful and… more
- Area Agency On Aging 1-b (Southfield, MI)
- The Appeals and Grievance Specialist is responsible for managing and resolving appeals and grievances in accordance with contractual, regulatory, and ... /grievance filings, and in administrative hearing proceedings. Duties Include: + The Appeals and Grievance Specialist is responsible for managing and resolving… more
- University of Michigan (Ann Arbor, MI)
- …Integrity (CDI) & Coding, the Clinical Denials Prevention & Appeals Specialist collaborates with CDI specialists, coders, quality analysts, providers, and ... Clinical Denials Prevention & Appeals Specialist Apply Now **Job Summary**...of each denial appeal. + Maintain records of denials, appeals outcomes, and training impact, and present… more
- St. Luke's University Health Network (Allentown, PA)
- …we serve, 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 ... records into EPIC, maintaining a 95% coding accuracy rate as measured through quality reviews. + Queries physicians when code assignments are not clear and… more
- Commonwealth Care Alliance (Boston, MA)
- …NCQA and other related quality program activities including: monthly case quality monitoring, coordination of training initiatives, coordination of Peer to ... monthly quality results and identifying opportunities for improvement and training and areas on noncompliance. In addition to NCQA program support, this… more
- Catholic Health (Buffalo, NY)
- Salary: 83,343.00-125,034.00 USD Facility: Administrative Regional Training Cntr Shift: Shift 1 Status: Full Time FTE: 1.000000 Bargaining Unit: ACE Associates ... role of management and oversight of team Summary: The Clinical Denials and Appeals , Clinical Supervisor is responsible for the people, carrying out and documenting… more
- State of Colorado (Lake County, CO)
- … - Leadville ($500/mo housing - CDL Training Provided) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5100595) Apply Highway Maintenance ... Specialist - Leadville ($500/mo housing - CDL Training Provided) Salary $59,400.00 - $60,000.00 Annually Location Lake...roadways open and safe. Your work also positively impacts quality of life for all Coloradans and visitors and… more
- State of Colorado (Prowers County, CO)
- Highway Maintenance Specialist - Granada (CDL Training w/ Permit) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5093032) Apply Highway ... Maintenance Specialist - Granada (CDL Training w/ Permit)...roadways open and safe. Your work also positively impacts quality of life for all Coloradans and visitors and… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Training Specialist II Job Category: Administrative, HR, Business Professionals Department: CSC Appeals & Grievances Location: Los ... achieve that purpose. Job Summary The Customer Solution Center Training Specialist II is responsible for conducting...the verticals of CSC which includes working with the Quality Review team to identify points of training… more
- State of Colorado (Grand Junction, CO)
- CDA-Large Scale/Hybrid Inspector (Compliance Specialist II; CDL Driver) $2,000 Signing Bonus Print ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5096046) Apply CDA-Large Scale/Hybrid Inspector (Compliance Specialist II; CDL Driver) $2,000 Signing Bonus Salary $50,856.00… more
- Globus Medical, Inc. (Collegeville, PA)
- … service to all customer types. **Essential Functions** **:** + The Patient Access Specialist will adhere to quality of HFX Access service through QA, additional ... sense of urgency to deliver innovations that improve the quality of life of patients with musculoskeletal disorders. Our...Reporting to the Supervisor, Patient Access, the Patient Access Specialist will focus on providing payer coverage support to… more
- State of Colorado (Denver, CO)
- Benefits Specialist - Administrator II MHTLH Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5097180) Apply Benefits Specialist - ... at any time. This position is the centralized benefits specialist for the MHTL Homes and is responsible for...able to advocate on behalf of clients, including navigating appeals processes. + Interpersonal & Empathy Skills: A high… more
- LA Care Health Plan (Los Angeles, CA)
- …Audit Readiness Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... Job Summary The Customer Solution Center (CSC) Audit Readiness Specialist II is responsible for the execution, oversight, and...Business Analyst to track, trend, and analyze results of Quality Assurance (QA) scorecards for training and… more
- Independent Health (Buffalo, NY)
- …complex clinical presentation with correlating coding complexity. They will aid in training other team members, evaluating appeals , and share audit trends ... fosters growth, innovation and collaboration. **Overview** The Clinical & Coding Specialist -Senior will be responsible for reviewing coding and clinical decisions on… more
- State of Colorado (Larimer County, CO)
- Highway Maintenance Specialist - Fort Collins Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5100609) Apply Highway Maintenance Specialist ... your passions into a career as a Highway Maintenance Specialist . CDOT has a vacancy for a Highway Maintenance...roadways open and safe. Your work also positively impacts quality of life for all Coloradans and visitors and… more
- State of Colorado (Ouray County, CO)
- Highway Maintenance Specialist - Ridgway Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4924906) Apply Highway Maintenance Specialist - ... your passions into a career as a Highway Maintenance Specialist . CDOT has a vacancy for a Highway Maintenance...roadways open and safe. Your work also positively impacts quality of life for all Coloradans and visitors and… more
- US Tech Solutions (RI)
- **Job Title: Prior Authorization Specialist ** **Location: Fully remote** **Duration: 12 months contract** **Job Description:** + Prior Authorization Specialist ... and/or resolve coverage requests. + Escalate issues to Coverage Determinations and Appeals Learning Advocates and management team as needed. + Must maintain… more
- State of Colorado (Grand Junction, CO)
- Employment First Specialist (HCT III) - Grand Junction Regional Center **Western Slope** Print ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5092648) Apply Employment First Specialist (HCT III) - Grand Junction Regional Center **Western… more
- City and County of San Francisco (San Francisco, CA)
- …School District, or San Francisco City College, working within the Communication Specialist (9252) classification. San Francisco is a vibrant and dynamic city, on ... is sustained by our City's commitment to heighten the quality of life for the diverse population of San...of San Francisco has to offer. The 9252 Communications Specialist is used by the Humans Services Agency (HSA),… more