- Monster (New Paltz, NY)
- …to existing policies and procedures for the assigned area. Reviews and processes correspondence on a daily basis. Reviews and processes Explanation of Benefits for ... support to senior representatives such as mailing paper claims, preparing spreadsheets for appeals , or maintaining data spreadsheets as directed by the manager … more
- LA Care Health Plan (Los Angeles, CA)
- Registered Nurse (RN) Manager , Appeals and Grievances General Operations (Clinical) Job Category: Clinical Department: CSC Appeals & Grievances Location: Los ... to support the safety net required to achieve that purpose. Job Summary The Manager , Appeals & Grievances (A&G) & General Operations (Clinical) is responsible… more
- LA Care Health Plan (Los Angeles, CA)
- Manager , Customer Solution Center Appeals and Grievances Job Category: Management/Executive Department: CSC Appeals & Grievances Location: Los Angeles, CA, ... to support the safety net required to achieve that purpose. Job Summary The Manager , Customer Solution Center Appeals and Grievances is responsible for the… more
- BronxCare Health System (Bronx, NY)
- …the analysis and preparation of responses to payor denials and develop strong appeals for the purpose of securing reimbursement for acute care services provided to ... identification of patterns and trends identified during the course of appeals preparation. Conduct departmental performance improvement audits, analyze findings and… more
- Point32Health (MA)
- …Point32Health (https://www.point32health.org/) . **Job Summary** Under the direction of the A&G Manager , the Appeals & Grievances QA Auditor audits the quality ... of letters and keyed entries from the Grievance and Appeals systems. Checks cases built by other associates to ensure highest level of quality and timeliness.… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Quality Auditing Specialist II Job Category: Administrative, HR, Business Professionals Department: CSC Appeals & ... achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Quality Auditing (QA) Specialist II is...assisting the Appeal and Grievances Compliance, Training and QA Manager to develop a successful and cohesive unit with… more
- Elevance Health (Indianapolis, IN)
- …for system edits. + Coordinates research and responds to system inquiries and appeals . + Conducts research of claims systems and system edits to identify ... reviews to ensure proper coding was used. + Prepares correspondence to providers regarding coding and fee schedule updates....Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- GAP Solutions Inc (Arlington, VA)
- …Department of Defense Consolidated Adjudications Facility (CAF), the Navy Personal Security Appeals Board (PSAB), Air Force PSAB, WHS Correspondence Analysis ... meets specific DOHA investigative standards; prepare memoranda of findings and correspondence in accordance with DOHA processes, and make appropriate entries into… more
- State of Colorado (Chaffee County, CO)
- CDOC - (Social Work/Counselor IV) Therapeutic Community Manager - (BUENA VISTA) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5021414) Apply ... CDOC - (Social Work/Counselor IV) Therapeutic Community Manager - (BUENA VISTA) Salary $7,229.00 - $10,121.00 Monthly...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- Clark County, NV (Las Vegas, NV)
- ASSISTANT MANAGER BUSINESS LICENSE OPERATIONS Print (https://www.governmentjobs.com/careers/clarkcounty/jobs/newprint/5032023) Apply ASSISTANT MANAGER BUSINESS ... Department is seeking qualified candidates to apply for the Assistant Manager Business License Operations position. This position plans, supervises, reviews and… more
- City and County of San Francisco (San Francisco, CA)
- …at large. The Senior Community Development Specialist I / Multifamily Project Manager performs multifamily housing finance work, which may include: + preserving the ... confidential information and preparing a variety of reports, memoranda, and correspondence . + invoicing, calculating accrued interest, collecting and processing loan… more
- State of Colorado (Chaffee County, CO)
- CDOC - Corrections Case Manager I (BVCC) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5085391) Apply CDOC - Corrections Case Manager I ... into society. Primary job duties and responsibilities for Case Manager I positions include, but are not limited to:...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (Limon, CO)
- Civil Engineering Project Manager I - Limon Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5080190) Apply Civil Engineering Project ... Manager I - Limon Salary $79,908.00 - $87,888.00 Annually...do, including hiring, employment, and advancement opportunities. Notifications: All correspondence regarding your status in the selection/examination process will… more
- Mount Sinai Health System (New York, NY)
- …as per department protocol (IPRO Discharge Appeals / Insurance requests) + Support Appeals Nurse / Manager by confirming status of denials + Tracking status ... of the Case Management Department by monitoring all incoming correspondence and ensuring it reaches the responsible individuals. Must...+ Requests or provides Medical Records as required for appeals , On / Off-site Insurance reviews + Implements… more
- Clark County, NV (Las Vegas, NV)
- PRINCIPAL MANAGEMENT ANALYST - PROJECT MANAGER Print (https://www.governmentjobs.com/careers/clarkcounty/jobs/newprint/5043330) Apply PRINCIPAL MANAGEMENT ANALYST ... - PROJECT MANAGER Salary $41.31 - $61.02 Hourly Location Clark County...Prepares a variety of technical, statistical and narrative reports, correspondence and other written materials. + Contributes to the… more
- City of New York (New York, NY)
- …and progress. Uses computers to maintain files and generate reports, correspondence , and other paperwork. - Investigates and advises the agency concerning ... contract disputes, and appeals on the rejection of equipment, materials, or workmanship;...community and members of the public. Prepares reports and correspondence for approval in dealings with contractors and the… more
- Sharp HealthCare (San Diego, CA)
- …**Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered ... Nurse (RN) - CA Board of Registered Nursing; Accredited Case Manager (ACM) - American Case Management Association (ACMA); Master's Degree; Bachelor's Degree in… more
- Transdev (North Las Vegas, NV)
- Labor Relations Manager The Labor Relations Manager provides support to the Area General Manager , Director of Human Resources, and Operations Teams on labor ... program of the property jointly with the Area General Manager . + Research, compile, and prepare data for use...reports, memos, letters, and other professional internal and external correspondence . + Submit standard monthly reports to the client.… more
- State of Colorado (Colorado Springs, CO)
- Assistant Office Manager (Colorado Springs) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5084209) Apply Assistant Office Manager ... commercial driver licenses, and identification cards. Senior Technician - Assistant Office Manager Duties: Duties include, but are not limited to: + Assists the… more
- The County of Los Angeles (Los Angeles, CA)
- …quality assessment and assurance monitoring processes; and handle informal complainant appeals . Health Facilities Program Manager , Nursing positions are required ... HEALTH FACILITIES PROGRAM MANAGER , NURSING Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4626091) Apply HEALTH FACILITIES PROGRAM MANAGER… more
