- Conduent (Baton Rouge, LA)
- …**Are you eager to learn new skills and help adults in need?** As an Appeals Coordinator you will represent the customer, the Louisiana Department of Health ... role, you will:** + Review decision/denial letters on new appeals requests received, research data and materials to accumulate...to:** + Prepare summaries of evidence + Prepare for appeals + Document required reporting for position + Utilize… more
- Insight Global (Tustin, CA)
- Job Description An employer is looking for a remote Appeals & Grievances Coordinator who will be responsible for managing and resolving appeals and ... and external stakeholders. Key Responsibilities - Review, research, and process appeals and grievances in compliance with company policies and regulatory… more
- Dignity Health (Rancho Cordova, CA)
- …This position is hybrid in-office and work from home.** **Position Summary:** The Appeals and Grievances Coordinator is responsible for supporting the appeals ... department team members by managing and coordinating the appeals and grievance process. This role involves: - facilitating...and grievances. Acting a subject matter expert (SME), the Coordinator will work closely with internal teams and external… more
- Centene Corporation (Little Rock, AR)
- …practice in Arkansas.** **Position Purpose:** Act as the liaison for all statewide appeals , fair hearings, review organizations, and other external type appeals . ... both State and NCQA requirements. + Review clinical information for all appeals utilizing nationally recognized criteria to determine medical necessity of services… more
- Centene Corporation (Phoenix, AZ)
- …**Position Purpose:** Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members. ... verbal and written member and provider complaints, grievances and appeals + Prepare response letters for member and provider...response letters for member and provider complaints, grievances and appeals + Maintain files on individual appeals … more
- Centene Corporation (Phoenix, AZ)
- …Purpose:** Analyze and resolve verbal and written claims and authorization grievance/ appeals from providers and members. Resolve all State inquires related to ... complaints, grievances and appeals . + Review and process member and provider grievances...+ Review and process member and provider grievances and appeals within federal, state and organizational regulations and policies… 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
- CVS Health (Phoenix, AZ)
- …+ Verify caller enrollment status with Mercy Care Plan. + Collect and document accurate demographic information from members or callers, as well as from Mercy Care ... systems. + Confirm details such as whether members receive special assistance (applicable to members with serious mental illness). + Utilize the QuickBase database to complete intake forms, ensuring documentation of members' reasons for calling is thorough and… more
- University of Southern California (Los Angeles, CA)
- …Ensures students complete assigned outcomes. Provides information as needed to the appeals coordinator . + Communicates and provides information about the ... Student Conduct / Community Expectations Coordinator Office of Community Expectations (OCE) Application Process: Please include a cover letter with your resume/CV.… more
- University of Southern California (Los Angeles, CA)
- …Ensures students complete assigned outcomes. Provides information as needed to the appeals coordinator . + . Communicates and provides information about the ... of conduct and conduct processes. Job Description The Academic Integrity Coordinator is responsible for Investigating, processing and resolving reported incidents of… 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
- City of New York (New York, NY)
- …Supervisor to oversee the duties and train the professional staff in the Appeals Bureau. Specific duties will include, but are not limited to, training, distributing ... attorneys: JOB RESPONSIBILITIES: - Maintaining a working knowledge of court rules and Appeals Bureau policies and helping the Bureau Chief implement such policies. -… more
- CVS Health (Baton Rouge, LA)
- …Must reside in Louisiana Responsible for intake, investigation and resolution of appeals , complaints and grievances scenarios for all products, which may contain ... responses from multiple business units. Ensure timely, customer focused response to appeals , complaints and grievance. Identify trends and emerging issues and report… more
- State of Colorado (Denver, CO)
- Records Coordinator Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5164116) Apply Records Coordinator Salary $4,906.00 - $6,825.30 ... lovers, runners and more. Join our team! The Records Coordinator is primarily responsible for effectively tracking and coordinating...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)
- Medical Operations Coordinator (Nurse V) - Lookout Mountain Youth Services Center Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5166280) Apply ... Medical Operations Coordinator (Nurse V) - Lookout Mountain Youth Services Center...if your application is eliminated. You will find the appeals process, the official appeal form, and how to… more
- State of Colorado (CO)
- Project Coordinator Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5166423) Apply Project Coordinator Salary $58,872.00 - $76,536.00 ... https://www.colorado.gov/pacific/dhr/student-loan-forgiveness-programs . https://dhr.colorado.gov/dhr-resources/student-loan-forgiveness-programs We are looking for a Project Coordinator for the Enterprise Project Management Office of the… more
- State of Colorado (Colorado Springs, CO)
- Special Education Site Coordinator - Spring Creek Youth Services Center Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5159087) Apply Special ... Education Site Coordinator - Spring Creek Youth Services Center Salary $2,889.69...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- Elderwood (Waverly, NY)
- Salary $ 20 / $ 22 Overview Managed Care Coordinator Overview Mon-Fri 8am-4pm The Managed Care Coordinator assists and supports the LPN/RN MDS Coordinator ... updates as requested by Insurance Companies, handles Third Party appeals , peer to peers as applicable and with clinical...and with clinical oversight provided by the LPN/RN MDS Coordinator . Attends team meetings at the discretion of the… more
- Michigan State University (East Lansing, MI)
- …Title Executive Director of Accessibility Compliance and ADA/Section 504 Coordinator Position Summary Michigan State University (MSU) seeks an experienced ... to serve as the Executive Director of Accessibility Compliance and ADA/Section 504 Coordinator (ED and ADA/Section 504 Coordinator ) within the Office for Civil… more
- State of Colorado (Pueblo, CO)
- DWR - Decreed Augmentation Coordinator (PSRS II) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5151246) Apply DWR - Decreed Augmentation ... Coordinator (PSRS II) Salary $76,104.00 - $112,404.00 Annually Location...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
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