- Mount Sinai Health System (New York, NY)
- **Job Description** The Senior CBO Appeals Analyst position requires an in-depth knowledge of healthcare pricing/reimbursement processes and procedures including ... and timely fashion. In collaboration with the Underpayment Team manager, the Senior CBO Appeals Analyst will work to further the CBO's goals of enhancing… 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 day-to-day ... 011540 CCA- Appeals & Grievances **Position Summary** Appeals and Grievances Specialist supports the Operations Department and the Appeals and Grievances team… more
- New York State Civil Service (Brooklyn, NY)
- …City Brooklyn State NY Zip Code 11210 Duties Description Standard Duties:As an Appeals Senior Unemployment Insurance Referee, you would be responsible for ... NY HELP Yes Agency Labor, Department of Title Senior Unemployment Insurance Referee - UIAB - Brooklyn...day-to-day supervision and oversight of a team of Appeals Administrative Law Judges (ALJ) and operations of UIAB… more
- City of New York (New York, NY)
- …78s Create People's appeals and Article 78s manual Perform other duties of senior Appeals Bureau ADA, including: Represent the People of the State of New ... and Article 78 requests and simultaneously handle post-conviction litigation, including direct appeals , Article 440 motions, and federal writs of habeas corpus. JOB… 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
- 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 ... and concerns regarding quality of care or service. PresentsMember appeals to the Plan Medical Staff and Center for...dental and domestic partners. Perhaps just as important, from senior management on down, we encourage an atmosphere of… more
- GEHA (Lee's Summit, MO)
- …+ Develop and deliver reports and presentations to stakeholders, including senior management to drive informed decision-making and ensure transparency in efforts. ... environment of continuous improvement Collaborate with internal stakeholders to include senior management to ensure comprehensive and efficient resolution of issues… more
- Wells Fargo (Charlotte, NC)
- …consultants to gather data and support valuations, and manage property tax audits and appeals as needed. **Business Licenses** The Senior Manager will manage the ... **About this role:** Wells Fargo is seeking a **Sales and Use Tax Senior Manager** responsible for overseeing all aspects of transaction tax compliance and… more
- NTT America, Inc. (Plano, TX)
- …adaptable, and forward-thinking organization, apply now. We are currently seeking a Delivery Senior Manager to join our team. NTT DATA is seeking to hire a ... **Medicare Appeals Clinical Leader** to lead service delivery engagements and...recommendations and interpretations of records. + Prepare reports for senior management on appeal trends and compliance status. **Requirements:**… more
- Houston Methodist (Sugar Land, TX)
- At Houston Methodist, the Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical ... denial management and appeals process, as applicable, in collaboration with clinical team partners. This position uses sound clinical judgement in the Utilization… more
- City and County of San Francisco (San Francisco, CA)
- …. Under general supervision, the Senior Geographic Information Systems (GIS) Analyst ... functions outlined in the 1053 IS Business Analyst - Senior Minimum Qualifications: Education: An associate degree in business...to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or… more
- City and County of San Francisco (San Francisco, CA)
- …. Under general direction from the Environmental Affairs Manager, the Senior Environmental Planner will successfully prepare and manage federal and state ... airport projects/programs, and obtain resource permits when required. The Senior Environmental Planner will work collaboratively in a team...to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or… more
- Staffing Solutions Organization (Albany, NY)
- …workforce, which is a reflection of our clients and the people they serve. ** Senior Healthcare Program Specialist (Level 2 or 3) - Albany, NY** **Division of ... the new eligibility system for New York's Complex Medicaid population, and the new appeals management system. The individual will act as a liaison between the DEMI… more
- CVS Health (Springfield, IL)
- …it all with heart, each and every day. **Position Summary** As a Senior Analyst, Business Analytics within the Pricing Operations organization, you will be ... supporting pricing and appeals reporting for Caremark clients. In this role you...be responsible to generate standard and customized pricing and appeals reporting in order to meet deadlines driven and… more
- City and County of San Francisco (San Francisco, CA)
- …School District, or San Francisco City College, working within the 1823 Senior Administrative Analyst classification. San Francisco is a vibrant and dynamic city, ... Compensation Info) (https://careers.sf.gov/classifications/) + Recruitment ID: E2P-1823-E10153 As a Senior Administrative Analyst, you will be responsible for directing… more
- City and County of San Francisco (San Francisco, CA)
- …City and County of San Francisco is looking to bring on board multiple Senior Human Resources Analysts to help departments in hiring, supporting, and retaining a ... City and County of San Francisco has to offer. Senior Human Resources Analysts are responsible for hiring, developing,...to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or… more
- City and County of San Francisco (San Francisco, CA)
- …right fit. The City and County of San Francisco is looking to hire multiple Senior Administrative Analysts to be part of the City workforce of nearly 40,000 staff ... County of San Francisco has to offer. As a Senior Administrative Analyst, you will be responsible for directing...to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or… more
- Independent Health (Buffalo, NY)
- …fosters growth, innovation and collaboration. **Overview** The Clinical & Coding Specialist- Senior will be responsible for reviewing coding and clinical decisions on ... They will aid in training other team members, evaluating appeals , and share audit trends across the team. Expertise...audit tips across the team. The Clinical & Coding Specialist- Senior will support the leadership in Hospital Audit in… more
- City and County of San Francisco (San Francisco, CA)
- …by clicking the "Apply Now" button. Under general direction, the 2550 Senior Occupational Therapist supervises and participates in the treatment and rehabilitation ... patient care and meet SFDPH mission and values. The Senior Occupational Therapist (2550) may perform other duties as...Rule 111A.35.1. The standard for the review of such appeals is 'abuse of discretion' or 'no rational basis'… more
- CVS Health (Richmond, VA)
- …we do it all with heart, each and every day. **Position Summary** The Senior Network Relations Analyst is responsible for the accurate and timely validation and ... Staff may be responsible for reviewing claims data and information. The Senior Network Relations Analyst is responsible for monthly Access and Availability… more