- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Quality Auditing Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: ... net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Quality Auditing (QA) Specialist II is responsible for… more
- Johns Hopkins University (Middle River, MD)
- …and rejections processes to resolve standard issues or escalate to a more senior specialist . **Specific Duties & Responsibilities** _Procedural Knowledge_ + Uses ... file or pull EOB batches. + Identifies and escalates non-standard appeals to a higher level specialist . + Informs the supervisor / Production Unit Manager of… more
- Johns Hopkins University (Middle River, MD)
- … and rejections processes to resolve standard issues or escalate to a more senior specialist . **Specific Duties & Responsibilities** + Uses A/R follow-up systems ... file or pull EOB batches. + Identifies and escalates non-standard appeals to a higher-level specialist . + Informs the supervisor / Production Unit Manager of… more
- American Red Cross (Lubbock, TX)
- …Disaster Health Services and Disaster Mental Health. We are currently seeking a Sr . Volunteer Recruitment Specialist . The ideal candidate must reside or be ... CAREER IS A FORCE GOOD (Key Responsibilities): + The Sr . Recruitment Specialist is responsible for developing...Insurance: Short + Long Term * Service Awards and recognition Apply now! Joining our team will provide you… more
- American Red Cross (Bangor, ME)
- …Red Cross, your uniqueness can shine! The American Red Cross is seeking a Senior Volunteer Engagement Specialist to work to support our North New England ... our Bangor office. WHAT YOU NEED TO KNOW: A Sr . Volunteer Engagement Specialist is responsible for...is thorough and documented. + Facilitate formal and informal recognition efforts and events to promote community and honor… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …help us transform healthcare? Bring your true colors to blue. What We Need The Senior Audit Specialist role will review paid claims for coding accuracy in ... opportunities for improvements by reviewing BCBSMA Medical and Payment policies, and review appeals to support the validity of the projects performed. We are looking… more
- Deloitte (Rosslyn, VA)
- …and work objectives + Demonstrated ability to write clearly and in a manner that appeals to a wide audience + Experience working with Lean Six Sigma + Well versed ... in Business Process Re-Engineering + Previous hands on experience with value stream mapping and predictive modeling Information for applicants with a need for accommodation:… more
- Sacramento County (Sacramento, CA)
- Senior Personnel Specialist Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/3578041) Apply Senior Personnel Specialist Salary ... at 5:00 pm on: 4/4/24, 4/18/24, 5/16/24 (final) The Senior Personnel Specialist is the lead worker...Street, Room 2640, Sacramento, CA 95814, telephone: ###. Such appeals must be filed within thirty (30) calendar days… more
- Clark County, NV (Las Vegas, NV)
- SENIOR LEGAL OFFICE SPECIALIST Print (https://www.governmentjobs.com/careers/clarkcounty/jobs/newprint/4470024) Apply SENIOR LEGAL OFFICE SPECIALIST ... Court is seeking qualified candidates to apply for the Senior Legal Office Specialist position. The ideal...printed materials and a computer screen, and hearing and speech to communicate in person or over the telephone.… more
- Clark County, NV (Las Vegas, NV)
- SENIOR AIR QUALITY SPECIALIST Print (https://www.governmentjobs.com/careers/clarkcounty/jobs/newprint/4466399) Apply SENIOR AIR QUALITY SPECIALIST ... of Environment and Sustainability is seeking candidates for a Senior Air Quality Specialist . As a member...printed materials and a computer screen; and hearing and speech to communicate in person or over the telephone.… more
- Sacramento County (Sacramento, CA)
- Senior Behavioral Health Peer Specialist Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/2979607) Apply Senior Behavioral Health ... Street, Room 2640, Sacramento, CA 95814, telephone: ###. Such appeals must be filed within thirty (30) calendar days...best describes how you meet the minimum qualification for Senior Behavioral Health Peer Specialist . Current or… more
- MyFlorida (Macclenny, FL)
- SENIOR HUMAN SERVICES PROGRAM SPECIALIST - 60008102 Date: Apr 23, 2024 Location: MACCLENNY, FL, US, 32063 The State Personnel System is an E-Verify employer. For ... . Requisition No: 819963 Agency: Children and Families Working Title: SENIOR HUMAN SERVICES PROGRAM SPECIALIST - 60008102 Pay Plan:… more
- Federal Deposit Insurance Corporation (Washington, DC)
- …met. Independently resolves issues through direct contact with division and office senior staff members and with representatives of the FFIEC. Develops, implements, ... CISR, the Legal Division, and the FFIEC. Provides customer service to senior officials of banking organizations, their legal representatives, and other interested… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** Senior Contract Specialist works closely with Corporate Governance (Legal), Government Affairs, Product, Marketing, ... Insurance Administration surveys as needed and assigned. Responds to Central Appeals Unit, Executive Inquiry, Corporate Audit and other department inquiries that… more
- CVS Health (St. Paul, MN)
- …inquiries and problems. Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise. - Applies medical necessity ... written inquiries related to requests for pre-approval/pre-authorization, reconsiderations, or appeals . - Insures all compliance requirements are satisfied and all… more
- CVS Health (Albany, NY)
- …Required Qualifications - Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise . - Applies medical necessity ... written inquiries related to requests for pre-approval/pre-authorization, reconsiderations, or appeals . - Insures all compliance requirements are satisfied and all… more
- Iowa Department of Administrative Services (Des Moines, IA)
- Environmental Specialist Print (https://www.governmentjobs.com/careers/iowa/jobs/newprint/4286695) Apply Environmental Specialist Salary $50,731.20 - ... IA Job Type Full-time Job Number 24-01765 Agency 427 Department of Inspections, Appeals & Licensing Opening Date 04/25/2024 Closing Date 5/10/2024 11:59 PM Central… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Coding Charges & Denials Specialist is responsible for coordinating and monitoring the coding specific clinical charges and denial ... management and appeals process in a collaborative environment with revenue cycle...and findings to both front line team members and senior executives. + Communicates to partners, revenue cycle staff,… more
- Air National Guard Units (Fresno, CA)
- Summary This TRAFFIC MANAGEMENT SPECIALIST position is located in the Distribution Section of the Deployment and Distribution Flight, Logistics Readiness Squadron, ... EXCEPTED SERVICE, PERMANENT POSITION The primary purpose of the TRAFFIC MANAGEMENT SPECIALIST , GS-2130-9, is to serve as a Distribution Traffic Management … more
- HCA Healthcare (Brentwood, TN)
- …to join an organization that invests in you as a Clinical Denials Coding Review Specialist ? At Work from Home, you come first. HCA Healthcare has committed up to ... (tuition, student loan, certification support, dependent scholarships) + Colleague recognition program + Time Away From Work Program (paid...are looking for a dedicated Clinical Denials Coding Review Specialist like you to be a part of our… more