- CenterLight Health System (NY)
- JOB PURPOSE: The Claim Appeals and Audit Specialist will play a pivotal role in enhancing the efficiency and effectiveness of the claims department by timely and ... accurate processing of claims appeals and performing claims audit, ensuring payment integrity and...etc., and type/write documentation, etc. with accuracy. + Audio Hearing and Motor Skills (Language) Requirements - Must be… more
- St. Luke's University Health Network (Allentown, PA)
- …regardless of a patient's ability to pay for health care. The Coding Appeals Specialist retrospectively reviews patient medical records, claims data and coding ... are assigned to support the services/treatment rendered. The Coding Appeals Specialist also prepares appeal arguments and/or...record and abstracting of patient information. Corrected vision and hearing to within normal range. Hearing as… more
- Commonwealth Care Alliance (Boston, MA)
- 011540 CCA- Appeals & Grievances **Position Summary:** Appeals and Grievances Program Advisor monitors and supports the operations and compliance of the ... Appeals and Grievances department through many NCQA and other...NCQA requirements. + Coordinate BOH hearings with external State Hearing Board + Help with preparation of NCQA audit… more
- Molina Healthcare (Tacoma, WA)
- **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and correct clinical decisions for appeals outcomes within compliance ... standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical/medical reviews of previously denied cases in which a formal appeals… more
- State of Colorado (Denver, CO)
- ECMC Enforcement Advisor (Compliance Specialist IV) - Remote/Hybrid Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4887965) Apply ECMC ... Enforcement Advisor (Compliance Specialist IV) - Remote/Hybrid Salary $68,100.00 - $91,200.00 Annually Location Denver Metro, CO Job Type Full Time Job Number PHA… more
- Baptist Memorial (Memphis, TN)
- Overview Specialist -Denial Mitigation II RN Job Code: 21432 FLSA Status Job Family: FINANCE Job Summary The Denial Mitigation-Appeal Specialist II RN serves in a ... in order to defend our revenue. The Denial Mitigation-Appeal Specialist II RN reviews the denial received from the...may be required to defend appeal in a payer hearing or clinical meeting when indicated. The Denial Mitigation-Appeal… more
- Baptist Memorial (Memphis, TN)
- Overview Specialist -Denial Mitigation II RN Job Code: 21432 FLSA Status Job Family: FINANCE Job Summary The Denial Mitigation-Appeal Specialist II RN serves in a ... in order to defend our revenue. The Denial Mitigation-Appeal Specialist II RN reviews the denial received from the...may be required to defend appeal in a payer hearing or clinical meeting when indicated. The Denial Mitigation-Appeal… more
- State of Colorado (Routt County, CO)
- Highway Maintenance Specialist - Rabbit Ears Pass (CDL Required & $1000/mo Housing) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4957832) ... Apply Highway Maintenance Specialist - Rabbit Ears Pass (CDL Required & $1000/mo...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (Grand County, CO)
- Highway Maintenance Specialist - Winter Park (CDL Training Provided & $1000/mo Housing) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4957808) ... Apply Highway Maintenance Specialist - Winter Park (CDL Training Provided & $1000/mo...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (Montezuma County, CO)
- Highway Maintenance Specialist - Mancos Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4954311) Apply Highway Maintenance Specialist - ... your passions into a career as a Highway Maintenance Specialist . CDOT has a vacancy for a Highway Maintenance...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (Denver, CO)
- Employee Relations Specialist (HR Specialist IV) - Metro Denver Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4948842) Apply Employee ... Relations Specialist (HR Specialist IV) - Metro Denver...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (Denver, CO)
- Environmental Protection Specialist I, Hazardous Materials - Denver Metro Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4951471) Apply ... Environmental Protection Specialist I, Hazardous Materials - Denver Metro Salary $65,736.00...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (Golden, CO)
- Electronics Specialist II - Golden Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4944448) Apply Electronics Specialist II - Golden ... Node Sites across the State. About the Position The Electronics Specialist position will be inspecting, troubleshooting, maintaining, and documenting fiber-optic and… more
- Clark County, NV (Las Vegas, NV)
- PTH FAMILY SERVICES SPECIALIST Print (https://www.governmentjobs.com/careers/clarkcounty/jobs/newprint/4946012) Apply PTH FAMILY SERVICES SPECIALIST Salary ... Family Services is accepting applications for Part-Time Family Services Specialist with experience working in a Child Welfare setting....to read printed materials and a computer screen; and hearing and speech to communicate in person or over… more
- State of Colorado (Denver, CO)
- Project Manager - Environmental Protection Specialist II - 2616 Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4956318) Apply Project Manager ... - Environmental Protection Specialist II - 2616 Salary $74,604.00 - $89,520.00 Annually...Board, that person must file an appeal (petition for hearing ) within 10 days of the action or receipt… more
- State of Colorado (Denver, CO)
- Water Quality Media & Communications Specialist III - 1606 Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4937934) Apply Water Quality Media ... & Communications Specialist III - 1606 Salary $4,809.00 - $5,813.00 Monthly...Board, that person must file an appeal (petition for hearing ) within 10 days of the action or receipt… more
- State of Arkansas (Little Rock, AR)
- …also handle any appeals filed from an order issued from a hearing . Further, the Licensing Attorney will respond to verbal and written inquiries from insurance ... ATTORNEY SPECIALIST Date: May 27, 2025 Req ID: 49622...consumers. Occasionally, the Licensing Attorney handles litigation, including administrative appeals . Reviews and analyzes data and documentation related to… more
- Scottish Rite for Children (Dallas, TX)
- …committed to giving children back their childhood! Job Posting Title: Denials Specialist Location: Dallas - Hospital Additional Posting Details: Monday - Friday 8:00 ... payor. This includes online reconsiderations. + Follow specific payer guidelines for appeals submission + Escalate exhausted appeal efforts for resolution + Research… more
- Commonwealth of Pennsylvania (PA)
- Records Specialist 1 - SCI Waymart Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/4954994) Apply Records Specialist 1 - SCI Waymart ... (SCI) at Waymart is seeking a highly motivated Records Specialist 1 with excellent communication skills to join our...at ###@pa.gov . Telecommunications Relay Service (TRS): + 711 ( hearing and speech disabilities or other individuals). If you… more
- Commonwealth of Pennsylvania (PA)
- Retirement Benefits Specialist Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/4949968) Apply Retirement Benefits Specialist Salary ... Office and in multitasking to meet deadlines? If so, a Retirement Benefits Specialist position at the State Employees' Retirement System (SERS) might be the right… more