- Catholic Health Services (Melville, NY)
- …Long Island's Top Workplace! Job Details Position Summary: The Utilization and Appeals Coordinator will perform activities to help facilitate utilization ... management and appeals functions to include coordination of specific process and payment related activities. Position Responsibilities: Prepares necessary… more
- Henry Ford Health System (Troy, MI)
- RN PROVIDER APPEALS COORDINATOR - MEDICAL APPEALS - 40 HOURS WEEKLY - DAY SHIFT Full Time Benefit Eligible Schedule: Monday through Friday, 8:00AM to 4:30PM. ... Alliance Plan (HAP) is looking to grow our Medical Appeals Team with an experienced Registered Nurse! We are...and counting) and Utilization Review Coordinators (4) that review appeals for medical necessity using established medical criteria ,… more
- City of New York (New York, NY)
- …opportunities, improving health and safety, and increasing opportunities for equitable growth. The Appeals Operations Coordinator will be a key member of the ... families with moderate and middle incomes. Your Impact As the Appeals Operations Coordinator for the Division, you will bolster effective workflow and… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Coordinator I(Temp) Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los ... to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Coordinator I supports the Customer Solution Center Appeals &… more
- Evolent (Phoenix, AZ)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The ** Coordinator ** **,** ** Appeals and Grievances** at Evolent will serve as a point ... of contact for processing post determination reviews and appeals requests in accordance with departmental policies, regulatory requirements, and client contractual… more
- Munson Healthcare (Traverse City, MI)
- …experience in a revenue cycle role (billing, registration, insurance verification, referral coordinator , etc) . Ability to work independently and problem solve with ... of Utilization Management and works closely with the Utilization Management and Appeals team . Interacts independently with all Munson Health Care departments.… more
- Centene Corporation (Sacramento, CA)
- …**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
- Commonwealth Care Alliance (Boston, MA)
- …clinical, operations, pharmacy, dental, reporting, and member services. + Supports the Senior Appeals & Grievance Coordinator and A/G Coordinator in ... 011540 CCA- Appeals & Grievances **Position Summary** Appeals and Grievances Specialist supports the Operations Department and the Appeals and Grievances team… more
- CVS Health (Phoenix, AZ)
- …issues and may require coordination of responses from multiple business units. Appeals are typically more complex and may require outreach and deviation from ... outside plan sponsors or regulators. * Research and resolves incoming electronic appeals as appropriate as a "single-point-of-contact" based on type of appeal. *… more
- CVS Health (Phoenix, AZ)
- …from multiple business units. Ensure timely, customer focused response to complaints/ appeals . Identify trends and emerging issues and report and recommend solutions. ... This position can be anywhere in the United States. **Required Qualifications** 1 year experience that includes both HMO and Traditional claim platforms, products, and benefits, patient management, product, compliance and regulatory analysis, special… more
- Adecco US, Inc. (Cumberland, RI)
- ** Coordinator I - Prior Authorization & Appeals ** Pay Rate: $15 - 15.13/hr Schedule: Assigned 8-hour shifts between 8:00 AM - 8:00 PM CT (Mon-Fri) Training: ... Mon-Fri, 8:00 AM - 4:30 PM CT (2 weeks) Location: Remote (US only - must meet home office requirements) **Key Responsibilities** + Review and maintain compliance with ERISA, CMS, Medicaid, and client policies + Perform non-clinical prior authorization and… more
- State of Michigan (Lansing, MI)
- Departmental Specialist 13 - Appeals Review Officer - Legal Affairs Print (https://www.governmentjobs.com/careers/michigan/jobs/newprint/5049167) Apply ... Departmental Specialist 13 - Appeals Review Officer - Legal Affairs Salary $2,484.80 - $3,708.80 Biweekly Location Lansing, MI Job Type Permanent Full Time Job… more
- Ellis Medicine (Schenectady, NY)
- …the chart to fax or send for insurance denials or quality improvement organization appeals . + Assists UM Coordinator with data entry of insurance authorizations ... and denials. + Denial Management Activities + Assists Denial Management staff with clerical support; including facilitating MD to MD reviews. + Performs audit activities under the supervision of the Director of Case Management and Social Work Services. Ellis… more
- City of New York (New York, NY)
- …and Article 78 requests and simultaneously handle post-conviction litigation, including direct appeals , Article 440 motions, and federal writs of habeas corpus. JOB ... made through Office internal request system Make recommendations to Appeals Bureau Chief on viability of such appeals... Appeals Bureau Chief on viability of such appeals and communicate with other bureaus about requests Draft… more
- State of Colorado (Denver, CO)
- PROGRAM COORDINATOR - Remote - Part Time Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5058319) Apply PROGRAM COORDINATOR - Remote - ... existing volunteer local ombudsman programs across Colorado. The Volunteer Program Coordinator is responsible for developing a process for recruiting, screening,… more
- CVS Health (Frankfort, KY)
- …day. **Position Summary** 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)
- Recovery Services Coordinator Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5057805) Apply Recovery Services Coordinator Salary ... for Assistance in Transition from Homelessness (PATH) SAMHSA grant coordinator . This position is also a trainer on the...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- Montana State University (Bozeman, MT)
- …Classification Title Program Coord II Working Title Customer Experience Coordinator Brief Position Overview MSU Parking and Transportation Services seeks ... will perform all customer service duties, coordinate the unit's citation appeals process, and provide administrative support. Performs of customer service functions… 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/5074158) 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
- Insight Global (Nottingham, MD)
- Job Description Day to Day: Insight Global is looking for a Denial Coordinator to support a large hospital system in the Maryland/DC area. This person will be ... overseeing and managing the insurance denial and appeals process to minimize financial risk and improve reimbursement...to medical necessity and assess the feasibility of submitting appeals . * Draft medical summaries of denied cases for… more
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