- BroadPath Healthcare Solutions (Tucson, AZ)
- **Overview** 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
- Universities of Wisconsin (Whitewater, WI)
- …through the internal application process. Position Title: Assignments and Billing Coordinator Job Category: Academic Staff Employment Type: Regular Job Profile: ... Housing Coordinator II Job Duties: The Assignments and Billing ...complicated and sensitive housing-related issues, policy questions, requests, and appeals , including matters related to student resident disabilities and… more
- Jobleads-US (Chicago, IL)
- …and reviews common errors or misses with physicians and leadership. The Billing Coordinator reflects the mission, vision, and values of NM, adheres to the ... guidelines and all other regulatory and accreditation standards. The Billing Coordinator is responsible for processing charges, payments and/or adjustments for all… more
- Florida Atlantic University (Boca Raton, FL)
- …employee account. Position Summary: Florida Atlantic University is seeking a Coordinator , Student Financial Aid - Boca Raton, FL. Responsibilities: + Responsible ... includes processing of awards, revision requests, satisfactory academic progress appeals , counselor reports, and professional judgments. + Occasionally attend… more
- Jobleads-US (Miami, FL)
- …of CPT, ICD-10, charge entry, and claims management processes. Knowledge of appeals process and researching denials as applicable to business needs. Possesses ... effective verbal and written communication skills. Knowledge of Microsoft Systems Word, Excel, Power Point and Access is a must. Must be detail-oriented team player with excellent written and communication skills. Background in coding experience in other… more
- The Crucible (Oakland, CA)
- …HR generalist, administrative support specialist, full-charge bookkeeper or purchasing coordinator . Intermediate to advanced proficiency with QuickBooks or similar ... 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… more
- Catholic Health Services (Melville, NY)
- …Long Island's Top Workplace! Job Details Position Summary: The Utilization and Appeals Coordinator will perform activities to help facilitate utilization ... management and appeals functions to include coordination of specific process and payment related activities. Position Responsibilities: + Prepares necessary… more
- Motion Recruitment Partners (Birmingham, AL)
- Claims Appeals and Grievance Coordinator Birmingham, Alabama **Onsite** Contract $18/hr - $28/hr Are you detail-oriented, highly organized, and passionate about ... making a difference in healthcare? We are seeking several Appeals and Grievances Coordinators for an onsite contract opportunity in Birmingham, AL. In this role,… more
- Evolent (Nashville, TN)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The ** Coordinator , Appeals and Grievances** at Evolent is responsible for reviewing and ... regulations, and prior authorization experience. This role is distinct from other coordinator positions in that it is dedicated to case handling and documentation… more
- Centene Corporation (Salem, OR)
- …RN or LPN** **Oregon state license **Utilization review, case management, and appeals experience in a managed care setting is strongly preferred** **Position ... Purpose:** Act as the liaison for all statewide appeals , fair hearings, review organizations, and other external type appeals . Responsible for ensuring that all… more
- Nuvance Health (Danbury, CT)
- …Provides high quality administrative support to Clinical Denial Prevention & Appeals Specialist RNs, Physician Advisors (PAs) and other stakeholders in ensuring ... role is instrumental in liaising with all above parties to submit provider appeals to insurance companies including Medicare and Medicaid for the Nuvance Health… more
- AmeriHealth Caritas (Philadelphia, PA)
- …about us at www.amerihealthcaritas.com. **Responsibilities:** Reporting to the Supervisor, Appeals and Grievances, this position is responsible for the ... administrative tasks for coordination of member and/or provider appeals , the analysis of claims and appeals ,...provider appeals , the analysis of claims and appeals , and the review of medical management authorizations.; +… more
- CVS Health (Carson City, NV)
- …9am-1pm.** 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
- CVS Health (Baton Rouge, LA)
- …Prepares information and reports needed to address matters regarding complaints, appeals , and grievances. Carries out policies, procedures, and programs to ensure ... Prepares information and reports needed to address matters regarding complaints, appeals , and grievances. Carries out policies, procedures, and programs to ensure… more
- CVS Health (Springfield, IL)
- …+ Prepares information and reports needed to address matters regarding complaints, appeals , and grievances. Carries out policies, procedures, and programs to ensure ... Prepares information and reports needed to address matters regarding complaints, appeals , and grievances. Carries out policies, procedures, and programs to ensure… more
- City of New York (New York, NY)
- …its work. Job Duties and Responsibilities: - Serve as the Reasonable Accommodations Appeals Unit coordinator and processing incoming requests. - Maintain an ... agencywide list of Executive Assistants for agency leadership that is updated and shared on a monthly basis. - Serve as a co-preparer for travel alongside the Operations Manager on travel for the Commissioner and other COH office staff. - Maintain the… more
- Crossroads Hospice & Palliative Care (Green, OH)
- …backgrounds + Problem-solving skills to research and resolve discrepancies, denials, appeals , collections Billing Coordinator Schedule & Benefits: + Schedule: ... we can create lasting impacts that transcend medical treatment. Billing Coordinator Responsibilities: + Obtain referrals and pre-authorizations as required for… more
- CommonSpirit Health (Englewood, CO)
- …are seeking a highly skilled individual to develop and submit clinical appeals , expertly crafting physician-aligned letters based on federal and state regulations, ... audit-ready case files with denial rationales and P2P documentation, ensuring successful appeals across all levels (1-5), including IRO and ALJ reviews, utilizing… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Appeals Specialist II, under the direction of the Director of Denial Support Services, logs and reviews per documentation guidelines for report ... regarding denials that are resulting in retractions. As an Appeals Specialist II at Community Health Systems (CHS) -...with the follow-up teams. + Works closely with Denial Coordinator , Facility Denial Liaison, and Managed Care Coordinator… more
- State of Colorado (Denver, CO)
- Chronic Disease Sustainability and Policy Coordinator - Term Limited Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5108358) Apply Chronic ... Disease Sustainability and Policy Coordinator - Term Limited Salary $72,000.00 - $77,688.00 Annually...official appeal form, signed by you or your representative. Appeals to the State Personnel Board or the State… more
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