- Optum (San Juan, PR)
- …in reviewing, researching, investigating, negotiating and resolving all types of appeals and grievances. This position will communicate with appropriate parties ... regarding appeals and grievance issues, implications and decisions. In addition,...decisions. In addition, analyze and identifies trends for all appeals and grievances. Primary Responsibilities: Manage and resolve healthcare… more
- Annuity Health (Westmont, IL)
- Job Type Full-time Description A Remote Insurance Follow-Up Representative will be responsible for all collection functions for hospital and physician services. This ... companies on claim status, gathering and submitting any missing information, rebilling, appeals , and billing out secondary electronic or paper claims to all payers… more
- State of Colorado (Denver, CO)
- …Department of Law through the work of ten operational sections, , , Criminal Appeals , , , Revenue & Utilities, , & Environment, Division of Community Engagement, and ... for enforcement of consumer protection laws, prosecution of criminal appeals , antitrust laws, and certain natural resource and environmental...the official appeal form, signed by you or your representative . This form must be delivered to the State… more
- City Of Concordia (Concordia, KS)
- …liaison for the Planning Commission and the Board of Zoning Appeals preparing staff reports, providing required/requested information, and providing resultant ... required. Attendance at Planning Commission and Board of Zoning Appeals meetings may be required. JOB QUALIFICATIONS Ability to...insurance carrier. PHYSICAL DEMANDS The physical demands here are representative of those that must be met by an… more
- McCalla Raymer Leibert Pierce (Iselin, NJ)
- …documents, conducting discovery, trials and evidentiary hearings, state and federal appeals , and settlement negotiations. Position may be in-office, hybrid or fully ... settlement, case management conferences, motion arguments, trials, hearings and appeals . Communicate with clients to ensure quality representation and implementation… more
- City of Philadelphia (Philadelphia, PA)
- …Rights Unit, Tort Litigation Unit, Code Enforcement Unit, Labor & Employment Unit and Appeals Unit. The Civil Rights Unit represents the City of Philadelphia and its ... Communicate with and review the work of outside counsel Attend meetings as representative of the unit with other city departments and clients Analyze probable… more
- County of DuPage, CO (Wheaton, IL)
- …opinions, and staff expertise for zoning cases brought to the Zoning Board of Appeals and for Plat cases brought to Plat committee Provides technical assistance to ... the Development Committee, County Board, Building Board of Appeals , and the Plat Committee Maintains regular attendance and...Environment PHYSICAL REQUIREMENTS The physical demands described here are representative of those that must be met by an… more
- State of Colorado (Glenwood Springs, CO)
- …review must be submitted on the official appeal form, signed by you or your representative . This form must be delivered to the State Personnel Board by email, US ... of notice or acknowledgement of the department's action. For more information about the appeals process, the official appeal form, and how to deliver it to the State… more
- HCA Healthcare (Pasadena, TX)
- …to join an organization that invests in you as a Medical Insurance Claims Appeals Representative ? At Parallon, you come first. HCA Healthcare has committed up ... to make a difference. We are looking for a dedicated Medical Insurance Claims Appeals Representative like you to be a part of our team. **Job Summary and… more
- Covenant Health (Lubbock, TX)
- **Description** **Claims Appeals Representative ** **Works collaboratively with Case Management (CM) Leadership, Case Managers (CM), Complex Discharge Planners ... (CDP) and other Resource Center (RC) staff in the CM department to support maximum reimbursement for CHS from payors. Communicates clinical reviews and refers payor questions to appropriate CM. Collaborates with Patient Financial Services, Administration, CMs,… more
- State of Minnesota (St. Paul, MN)
- **Working Title: SMRT Appeals and Team Lead** **Job Class: Human Services Program Representative 2** **Agency: Human Services Dept** + **Job ID** : 87662 + ... eligible for telework._ The State Medical Review Team (SMRT) Appeals and Team Lead provides advanced technical leadership and...serves as the primary point of contact for SMRT's appeals process, representing the department in Fair Hearings and… more
- State of Nevada (NV)
- UNEMPLOYMENT INSURANCE REPRESENTATIVE 5 - Underfill for ESD Appeals Referee 1 APPROXIMATE ANNUAL SALARY - $61,721.28 to $91,496.16 PAY GRADE: 34 The salary range ... and objectives. This recruitment is for an Unemployment Insurance Representative 5, underfill for ESD Appeals referee 1. The incumbent will progress to the next… 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
- 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
- St. Luke's University Health Network (Allentown, PA)
- …a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all ... determination made by the government or commercial payors, or their auditor representative . + Facilitate clinical chart reviews to assist with supporting assigned… more
- St. Luke's University Health Network (Allentown, PA)
- …regardless of a patient's ability to pay for health care. The Coding Appeals Specialist retrospectively reviews patient medical records, claims data and coding of ... AMA CPT, are assigned to support the services/treatment rendered. The Coding Appeals Specialist also prepares appeal arguments and/or letters to support and defend… more
- Penske (Reading, PA)
- …audits, including negotiating with auditors and interfacing with taxing jurisdictions. -Perfect appeals and refund claims. -The position will require the ability to ... are required. **Physical Requirements:** -The physical and mental demands described here are representative of those that must be met by an associate to successfully… more
- Executive Office for US Attorneys and the Office of the US… (Richmond, VA)
- …an opportunity to work on their own caseload and handle their own trials and appeals as a representative of the United States. This office is hiring for ... two AUSAs in the Criminal Division of the Richmond Office. Guns, Violent Crimes, and Narcotics Unit: This Unit investigates and prosecutes a wide variety of violent and gang-related crimes, including murders, kidnappings, racketeering, firearms trafficking… more
- HANAC, Inc. (Astoria, NY)
- …integral part of a team with the immigration attorney, Board of Immigration Appeals (BIA) accredited representative , and support staff. The Immigration Paralegal ... will assist the staff attorney and the Program Director in providing legal services, education, and outreach, including coordination of community events, and working under attorney supervision to assist clients on Immigration law matters. The Paralegal will… more
- MyFlorida (Fort Lauderdale, FL)
- 856378-EMPLOYMENT SECURITY REPRESENTATIVE II-LW - 40046185 Date: Jul 21, 2025 The State Personnel System is an E-Verify employer. For more information click on our ... . Requisition No: 856378 Agency: Commerce Working Title: 856378-EMPLOYMENT SECURITY REPRESENTATIVE II-LW - 40046185 Pay Plan: Career Service Position Number:… more
