- BroadPath Healthcare Solutions (Tucson, AZ)
- …BroadPath is seeking a highly motivated and results-driven **UM RN Appeals Coordinator.** This role collaborates with clinical review staff, medical ... to ensure consistent clinical evaluation and processing of medical necessity appeals . Accurate documentation and detailed recordkeeping of notifications to members… more
- Stanford Health Care (Palo Alto, CA)
- …the Revenue Cycle Denials Management Department by managing and resolving clinical appeals related to government audits and denials. This position requires strong ... analytical and communication skills. The Clinical Government Audit Analyst and Appeals Specialist II will collaborate with clinical staff, coding professionals, and… more
- Hawaiian Electric (Honolulu, HI)
- …and property damage claims, from case inception to judgment and appeals ; advising officers, managers and employees regarding proposed legislation, newly enacted ... all aspects of litigation matters from case inception to judgment and appeals . SENIOR ASSOCIATE GENERAL COUNSEL (LITIGATION & REGULATORY) JOB FUNCTION: Provide… more
- Staffing Solutions Organization (Albany, NY)
- …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 ... + Interpret guidance and instructions related to Medicaid eligibility, enrollment, appeals processes, and notices from a requirements perspective; perform analysis… more
- PharmaCord (Lexington, KY)
- …includes completing benefit investigations, tracking prior authorizations / denial appeals , and assisting patients or other callers/stakeholders through resolution ... detailed records of reimbursement activities, including claims status, payments, and appeals . Generate reports and analysis as needed to identify trends and… more
- JS Perkins Consulting (Falls Church, VA)
- …and tools to support processing of DD 1131s Cash Collection Vouchers, appeals packages, and deposit activities (without directly preparing or submitting official ... organizing and preparing supporting documentation for Third Party Collection (TPC) appeals packages. Conduct quality assurance and data validation to ensure accuracy… more
- Offices, Boards and Divisions (Washington, DC)
- …in representing the United States in civil rights cases in the federal courts of appeals . Many of the Section's cases are appeals from district court judgments ... in cases originally handled by the Division's trial sections. Criminal: Investigates and prosecutes cases throughout the United States involving the interference with liberties and deprivation of rights defined in the Constitution or federal law. Criminal… more
- Stony Brook University (Stony Brook, NY)
- …of specialized aid programs, such as verification, professional judgment appeals , and communication campaigns. **Retention and Academic Partnership** + Partner ... on retention initiatives. + Serve on the Satisfactory Academic Progress (SAP) appeals committee. **Outreach and Education** + Conduct in-person and virtual workshops… more
- Stony Brook University (East Setauket, NY)
- …business functions including but not limited to: billing, claims analysis appeals , follow-up, financial assistance and customer service. **Duties of a Revenue ... on rejected or denied claims, improper payments and coding issues. + Process appeals . + Liaise with third party billing and collection agencies. + Identify issues… more
- Stanford Health Care (Palo Alto, CA)
- …- Payer clerical and technical denial review and request processing including basic appeals - Payment posting and batch reconciliation - Credit balance review and ... to payers + Reviewing and resolving payer rejections, denials, and performing appeals as necessary + Electronic or hardcopy claims editing and submission to… more
- Genmab (Berkeley Heights, NJ)
- …verifications, research of prior authorizations and support through the appeals processEvaluate and refer patients to appropriate financial assistance ... programsProvide high quality case management through:Assessing and documenting patient needs and services requestedEffectively communicate with the patient, their caregiver, their prescriber and office staff members when requiredAbility to have critical… more
- Universities of Wisconsin (Whitewater, WI)
- …complicated and sensitive housing-related issues, policy questions, requests, and appeals , including matters related to student resident disabilities and gender ... identity Advises internal and external stakeholders about housing units, contracts, and options Collaborates with campus groups and/or departments and maintains successful campus partnerships, while representing the interests of the division May supervise… more
- TGC Search (Dallas, TX)
- …processes and improve efficiency. Handle electronic billing submissions, budgeting, and appeals related to legal matters. Support a high-performing team dedicated to ... excellence in client service and billing. Requirements: 5+ years of billing experience in a law firm environment (leadership or supervisor experience preferred) Proficiency in both traditional billing and eBilling processes (experience with eBilling platforms… more
- PharmaCord (Jeffersonville, IN)
- …for coverage and provide education support for the office to submit pre-determinations, appeals and/or peer to peer reviews with payors, as applicable Assist offices ... to understand payor denied or underpaid claims and provide education, as applicable, for the office to resolve of rejected, denied or underpaid claims Educate HCPs, their office staff and/or patients on appropriate resources for questions about co-pay,… more
- PharmaCord (Jeffersonville, IN)
- …closure to include; benefit investigations, prior authorizations / denial appeals , determining financial qualifications for assistance programs and assisting ... patients or other callers/stakeholders through resolution (via email, inbound/outbound calls and using our patented technology, PharmaCord Lynk) by using your critical thinking skills and your knowledge of the program and industry rules and standards. This… more
- Defender Association of Philadelphia (Philadelphia, PA)
- …specialized practice units that provide representation from preliminary arraignments through appeals . Our model of client-centered advocacy is grounded in both ... zealous courtroom representation and active community engagement through initiatives such as Participatory Defense Hubs, expungement clinics, and other outreach events. Each year, we welcome a new class of Assistant Defenders. Following an intensive,… more
- Sprenger Wellspring Silver Maple (Lorain, OH)
- …and ancillary billing. Monthly review of outstanding balances. Responsible for appeals . Assists with insurance verifications when needed. The position offers a ... competitive wage based on experience, and many other benefits including: Health insurance with company paid life insurance Dental, Vision and Voluntary benefits 401k with company match Tuition reimbursement Opportunity for professional growth and development… more
- Pacifica Law Group LLP (Seattle, WA)
- …in the areas of municipal finance, public-private partnerships, litigation, appeals , public records, ethics, complex transactions, real estate, procurement, ... construction, school law and other areas of general municipal law for public and private sector clients. Responsibilities This is an excellent opportunity to join a sophisticated litigation practice and to work in a dynamic, expanding, team-oriented atmosphere… more
- Cohen Immigration Law Group, PC (Long Island City, NY)
- …and organize filings for removal defense, asylum, adjustment of status, waivers, appeals , and humanitarian cases. *Conduct legal research and stay current on ... immigration laws, regulations, and procedural changes. *Prepare and compile supporting evidence, exhibits, and case packets for hearings and interviews. *Communicate with clients to gather information, provide updates, and answer case-related questions.… more
- The Crucible (Oakland, CA)
- …include why you would be a good fit, what you'd bring to The Crucible and what appeals to you about this position. Due to the size of our team and the physical ... nature of our work, we are unable to respond to phone calls. Note: The Crucible does not have the resources to sponsor visas, nor any open positions eligible for the H-1B program. The Crucible fully and actively supports equal employment opportunities to all… more
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