- Manhattan District Attorney (New York, NY)
- …Case Management Services Civil Service Title: Community Associate Position Title: Assistant Supervisor Salary Range: $64,761 - $64,761 Job Description: The New York ... Attorney's Office (DANY) has an opening for an Assistant Supervisor in its Case Management Services Unit (CMS). In...Special Victims Division, Pathways to Public Safety Division, and Appeals Division, which handles all the Office's matters in… more
- St. Barnabas (Bronx, NY)
- …necessary to complete the job requirements. ** Ensures that claims, denials, and appeals are efficiently processed and reported on a regular schedule Ensures that ... and analysis (DRG, APC, Managed Care contracting) Hospital denials and appeals management experience Experience with managed care contracts, reimbursement and… more
- EmblemHealth (New York, NY)
- …Position Perform clinical and administrative reviews within the Grievance and Appeals department, ensuring accurate administration of benefits, execution of clinical ... appropriate clinical setting, and as a clinical resource to the non-clinical Appeals staff. Enter and maintain documentation in the appropriate workflow tools… more
- WMC Health (Valhalla, NY)
- …timeframe of the request. Provides clinical rational for standard and expedited appeals . Participate in peer-to-peer review with payors and/or complete appeals ... needed to discuss cases and problems. Participates in daily review of aggregate denials/ appeals with the Medical Director, peer, or the Clinical Review Supervisor… more
- United Nations (New York, NY)
- …* Monitors issues on conditions of service of staff and advises the supervisor of any developments and the work of the human resources assistants/HR partners. ... Assists in providing documentation and background materials relating to classification appeals . General * Assists in providing documentation and background materials… more
- PacificSource (Springfield, OR)
- …physical, behavioral, and oral health utilization management, and grievance and appeals . As appropriate, interface with appropriate regulatory agencies to influence ... Management departments and activities. As assigned, participate in relevant Manager/ Supervisor meetings including meetings related to Population health, Provider… more
- Waccamaw Dermatology (Myrtle Beach, SC)
- …and ensure that they are properly and closely monitored. Consults with supervisor or pharmacist to obtain clearance that treatment regimen is appropriate. Processes ... insurance companies, physicians and patients as required. Reveiws denials and submit appeals if requested by physician to get them approved from insurance companies.… more
- Alameda Alliance For Health (Alameda, CA)
- …Member Services Representatives are under the direction of a Member Services Supervisor , Manager and Director, and service our members through our call center ... the next business day following receipt). Interface with Grievance and Appeals , Claims, Enrollment, IT, Network Management, Pharmacy, Authorizations, and other… more
- Steward Health Care (Dallas, TX)
- …timelines. The Revenue Cycle Associate reports to the central business office supervisor or manager. Meets goals and objectives in assigned area; Complies daily ... a timely and compliant manner; Researches, prepares, and submits appeals to insurance companies; Details all actions taken on...and/or issues that may be trends and escalate to supervisor as needed; and Maintain strict confidentiality and adhere… more
- City of Plantation, FL (Fort Lauderdale, FL)
- …Continuous Description This is an exempt position which requires responsible supervisor and administrative work of high visibility involving managerial, technical, ... Knowledge of the functions of the Broward County Rules and Appeals , including the appeal processes certification, re-certification, and educational programs.… more
- Rezolut (Syracuse, NY)
- …including telephone calls, accessing payer websites, checking claim status, process appeals on denied and underpaid claims, etc. Identify issues and trends ... in monthly, quarterly and annual performance evaluation process with their Supervisor Respond timely to emails and telephone messages as appropriate Communicate… more
- Merced County Office of Education (Merced, CA)
- …the fiscal oversight of each school district in Merced County, hears appeals for student expulsion hearings and interdistrict transfers and operates Green Meadows ... Outdoor School. Job Summary Under general supervision of a Site Supervisor or Master Teacher, teach an assigned group of students using developmentally appropriate… more
- NORTH EAST MEDICAL SERVICES (Burlingame, CA)
- …evidence-based medical decision-making. Review and approve prior authorization requests, appeals , and other medical determinations in alignment with regulatory ... and resolving problems. Performs other job duties as required by manager/ supervisor . Qualifications QUALIFICATIONS: Education: MD or DO degree with an active… more
- Township of Edison (Edison, NJ)
- …renovations and constructions of buildings. Assists in the preparation of records of appeals to county and state tax boards. Answers inquiries and gives information ... Composes replies to routine correspondence. Refers errors and irregularities to supervisor . Assists in preparing and keeping up-to-date tax assessor's list and… more
- Addison Group (Hartford, CT)
- …in a timely manner Identify and report consistent billing issues to the supervisor Stay up-to-date with changes in medical billing and coding procedures Maintain ... Billing Strong understanding of EOBs (Explanation of Benefits) Knowledge of denials and appeals processes Ability to work independently and as part of a team… more
- State of Colorado (Aurora, CO)
- …within the community. Properly report and track incidents on campus for the supervisor to include in the federally mandated Clery reports. Work with law enforcement ... and Personnel Director's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, at spb.colorado.gov/board-rules. Supplemental Information This posting… more
- Mental Health Association of South Central Kansas (Wichita, KS)
- …Assist clients in completing Medicaid applications, renewals, and appeals , including gathering required documentation. Utilize trauma-informed, harm-reduction, and ... meetings, agency meetings, and trainings as required. Ensures appropriate notification to supervisor for absences and ensures that work is covered. Flexible in work… more
- Comal County, TX (New Braunfels, TX)
- …when appealed by drafting appellate briefs and arguing at the Court of Appeals . Screen incoming case reports from local agencies and present selected cases to ... the Grand Jury. Maintain larger caseload, as assigned by supervisor . Mentor Felony II Prosecutor, as assigned by ...supervisor . Mentor Felony II Prosecutor, as assigned by supervisor . Act as lead prosecutor for court, as assigned… more
- Point32Health (MA)
- …(https://www.point32health.org/) . **Job Summary** Under the general direction of the Manager, Appeals and Grievances the Supervisor , Appeals and Grievances ... and provide leadership for the daily operations of the Appeals and Grievances department. The supervisor represents the Appeals and Grievances Department and… more
- R1 RCM (Boise, ID)
- …sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our **Clinical Appeals Supervisor ** , you will help support clinicians who ... this remote position. **Here's what you will experience working as a Clinical Appeals Supervisor :** + Track and monitor the workflow of the clinical team daily… more
