- Harbor Health Services, Inc. (Mattapan, MA)
- …and consistency of decisions. Supervisory responsibilities for UM RN, Quality Analyst , Appeals and Grievances Specialist. Requirements: Bachelor's Degree ... of quality measures and other data by the Quality Analyst for report to regulatory agencies, including CMS and...communication to employees about QI efforts. Working with the Appeals and Grievances Specialist, maintains oversight of the Grievances… more
- FREEMAN (Dallas, TX)
- …existing and new product offerings. + Assist with managing sales/use tax audits and appeals . + Process and analyze business data to support sales and use tax audits ... and process improvement. + Assist with the integration of newly acquired companies' sales/use tax activities. + Provide excellent customer service by responding on a timely basis to business unit and external customer inquiries on sales and use tax matters… more
- Elevance Health (Cerritos, CA)
- **Title: Grievance/ Appeals Analyst I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... employment, unless an accommodation is granted as required by law._ The **Grievance/ Appeals Analyst I** is an entry level position in the Enterprise Grievance &… more
- Point32Health (MA)
- …the general direction of the Member Appeals and Grievance Supervisor the Appeals and Grievance Analyst is responsible per State and Federal regulations for ... the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual works… more
- Point32Health (Canton, MA)
- …general direction of the Member Appeals and Grievance Supervisor the Member Appeals and Grievance Analyst is responsible per State and Federal regulations ... the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual works… more
- Elevance Health (Tampa, FL)
- …for system edits. + Coordinates research and responds to system inquiries and appeals . + Conducts research of claims systems and system edits to identify ... adjudication issues and to audit claims adjudication for accuracy. + Perform pre-adjudication claims reviews to ensure proper coding was used. + Prepares correspondence to providers regarding coding and fee schedule updates. + Trains customer service staff on… more
- Henry Ford Health System (Troy, MI)
- …for the prompt and thorough investigation of medical and pharmacy member appeals and grievances for Health Alliance Plan's (HAP's): Commercial, Medicare Advantage, ... Medicare-Medicaid Program (MMP), and Medicaid lines of business. Analyst must identify trending issues on an ongoing basis and provide root/cause analysis when… more
- Ochsner Health (New Orleans, LA)
- …make a difference at Ochsner Health and discover your future today!** The Appeals Specialist is responsible for managing and resolving insurance claim denials and ... Collaborate with clinical staff and coding teams to obtain necessary documentation for appeals + Track and monitor appeal status, maintaining detailed records in the… more
- MTA (Long Island City, NY)
- … Analyst Series (Paratransit) Department: Paratransit Division/Unit: No-Show/Late Cancellation Appeals Reports To: Sr. Dir Paratransit SVC Eligibility Appeals ... - Represented by TWU): Min: $71,203 - Max: $84,295 No-Show/Late Cancellation Appeals As a Staff Analyst , you'll support the appeals process for no-show and… more
- HCA Healthcare (Nashville, TN)
- **Description** **Introduction** Do you have the career opportunities as a Benefits Analyst you want with your current employer? We have an exciting opportunity for ... caring group of colleagues. Do you want to work as a Vendor Relations Analyst where your passion for creating positive patient interactions is valued? If you are… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …will work remotely (Days, M- F). *Purpose of this position:*The Contract Variance Analyst provides foundational support in managing appeals related to payer ... **_SUMMARY_** We are currently seeking a *PFS Contract Variance Analyst ** *to join our Denials Analysis team. This full-time role… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …Contract Variance Analyst Senior is responsible for leading the end-to-end appeals process related to contract variances and fatal denials. This role serves as ... **_SUMMARY_** We are currently seeking a *PFS Contract Variance Analyst Senior** *to join our Denials Analysis team. This full-time role will work remotly (Days, M-… more
- City and County of San Francisco (San Francisco, CA)
- …Francisco and UC Law San Francisco. Under direction, the 1813 Senior Benefits Analyst performs complex benefits work for the City's health, dental, vision, Flexible ... an assigned benefit program. Additionally, the 1813 Senior Benefits Analyst directly oversees a team of Benefits Analysts and...to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or… more
- CalSTRS (Sacramento, CA)
- Job Posting: Legal Analyst State Teachers' Retirement System JC-500501 - Legal Analyst ASSOCIATE GOVERNMENTAL PROGRAM ANALYST $6,031.00 - $7,547.00 per Month ... is seeking a motivated individual to work as an Analyst II on the Operations team. Under the direction...CalSTRS legal program, and represents the System in litigation, appeals , and other legal matters. The Office of the… more
- City and County of San Francisco (San Francisco, CA)
- …and County of San Francisco has to offer. As a Senior Administrative Analyst , you will be responsible for directing and performing challenging, complex, and ... operations. + Providing a real-world example, a Senior Contracts Analyst could assist with procurement and contract administration related...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)
- …grants, contracts, budgets, finance, and/or program evaluation and planning. As an Administrative Analyst , you may work with a manager to perform research to develop ... the department. + Providing a real-world example, a Policy Analyst for the Office of the Treasurer & Tax...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)
- …that may impact the department. + Providing a real-world example, a Junior Policy Analyst for the Office of the Treasurer & Tax Collector could involve working to ... partners. + Providing a real-world example, a Junior Budget Analyst may have the opportunity to learn about the...to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or… more
- State of Colorado (Lakewood, CO)
- Watch Center Analyst Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5172209) Apply Watch Center Analyst Salary $48,432.00 - $77,484.00 ... as local, state and federal partners. The Watch Center analyst will make operational decisions pertaining to raw information...Procedures, 4 CCR 801, for more information about the appeals process. The State Personnel Board Rules and Personnel… more
- City and County of San Francisco (San Francisco, CA)
- …years of verifiable professional human resources experience, similar to 1241 Human Resources Analyst , in one or more of the following areas of activity: recruitment ... Additional qualifying work experience as a professional human resources analyst may be substituted for up to two years...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)
- …County of San Francisco has to offer. In the role of Principal Administrative Analyst , you will lead and perform challenging and complex projects that span areas ... in this selection process, which includes the following: Administrative Analyst Core Exam (Weight: 60%) Candidates meeting the Minimum...to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or… more
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