- 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
- Elevance Health (Atlanta, GA)
- **Audit & Reimbursement Senior ** _Location:_ This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... Services to transform federal health programs._ The **Audit and Reimbursement Senior ** will support our Medicare Administrative Contract (MAC) with the federal… 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
- Molina Healthcare (Davenport, IA)
- …for leading, organizing and directing the activities of the Grievance and Appeals Unit that is responsible for reviewing and resolving member and provider ... research and resolution of the complex or escalated and high dollar appeals , grievances, and/or complaints from Molina members, providers and related outside… more
- Independent Health (Buffalo, NY)
- …timely and consistent review and investigation of provider and/or member complaints and/or appeals . The Contractual Reviewer- Senior will be required to rely on ... to collaborate with multiple departments and associates to properly investigate appeals /complaints. The Contractual Reviewer- Senior will also be responsible for… 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
- Trinity Health (Columbus, OH)
- …analysis, audit, provider relations and more. **Position Purpose:** The Appeals and Grievance Coordinator is responsible for the processing and resolution ... of appeals , grievances and disputes from members and providers **What...regular monitoring efforts and reports trending and outliers to senior management. + Responsible for ensuring 5-Star (maximum) ratings… 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
- University of Colorado (Boulder, CO)
- …questions or concerns. Assists students with problem-solving and campus resources. Advances appeals or grievances to the senior program manager as appropriate. ... at the end of every session. + Assists the Senior Online Program Manager in sending regular messages through...maintains procedural documents. + Servers as backup for the Senior Online Program Manager. + Attends and participates in… 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
- City and County of San Francisco (San Francisco, CA)
- …Facebook (https://www.facebook.com/portofsanfrancisco) . Under general direction, the Port's Senior Waterfront Property Manager is responsible for marketing, leasing ... properties within the parameters of a regulatory environment. The Senior Property Manager is also responsible for carrying out,...to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or… 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
- 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)
- …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)
- …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
- 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)
- …status. The list resulting from this recruitment may be used to fill 2558 Senior Physical Therapist positions for the next six months. Some positions may have ... (PI) related to the physical therapy department. The 2558 Senior Physical Therapist may perform other duties as assigned/required....Rule 111A.35.1. The standard for the review of such appeals is 'abuse of discretion' or 'no rational basis'… more
- Movn Health (CA)
- Role Summary Movn Health is seeking a highly experienced Senior Medical Biller & A/R Specialist to take full ownership of claims processing and accounts receivable ... recovery. This is a hands-on, senior -level role focused on accelerating cash flow, reducing outstanding...with a proven track record in A/R recovery, claim appeals , and payer follow-ups. Experience in startup environments and… more
- New York State Civil Service (Albany, NY)
- NY HELP Yes Agency Education Department, State Title Senior Attorney, Assistant Attorney 1, (NY HELPS) Box OEP-26/14724 Occupational Category Legal Salary Grade 25 ... Department's (NYSED) Office of Education Policy is seeking candidates for a Senior Attorney position in the Office of School Personnel Review & Accountability… more
- AC Disaster Consulting (Tallahassee, FL)
- …evolving threats and hazards facing our nation. Position Summary: Job Title: Senior Individual Assistance Program Specialist- Multiple Levels ( Senior Consultant ... for that level, and a corresponding level position must be available. + Senior Consultant II: $90-100k/annual + Managing Consultant: $90-115k/annual + Senior … more
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