- UnitedHealth Group (Cypress, CA)
- …individual case review for appeals and grievances for various health plan and insurance products, which may include PPO, ASO, HMO, MAPD, and PDP. The appeals ... the US as you take on some tough challenges. Primary Responsibilities: The Appeals and Grievances Medical Director is responsible for ongoing clinical review and… more
- St. Luke's University Health Network (Allentown, PA)
- …a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all ... for the purpose of appealing proposed DRG and coding changes by insurance providers or their respective auditors JOB DUTIES AND RESPONSIBILITIES: Conduct… more
- Regal Medical Group, Inc. (Northridge, CA)
- …and maintaining a healthy balance between work and life. Our dedication to our staff is evident in our comprehensive benefits package. We offer a very generous ... Employer-paid comprehensive medical, pharmacy, and dental for employees Vision insurance Zero co-payments for employed physician office visits Flexible Spending… more
- Legal Aid Chicago (Chicago, IL)
- …in poverty in metropolitan Chicago. Each year our attorneys, volunteers, and staff help resolve civil legal problems, including domestic violence, consumer fraud, ... : Legal Aid Chicago's Immigration Project seeks a full-time Staff Attorney with a minimum of two years' experience...Office of Immigration Review and the Board of Immigration Appeals . Areas of primary practice include Asylum; U Visa… more
- Torrance Memorial Medical Center (Torrance, CA)
- …Rep is responsible for reviewing denied claims and carrying out the appeals process. Works to maintain third-party relationships, including responding to inquiries, ... Knowledgeable of state/federal laws that relate to contracts and to the appeals process. Assists the Denials Management Senior Analyst with reports and provides… more
- Stony Brook University (Stony Brook, NY)
- …coordinate and expedite required services. Perform minor joint procedures. Work with clinic staff together for insurance appeals and pre-authorizations as ... approved by the supervising physician. Collaborate with supervising physician and nursing staff in the facilitation and interpretation of laboratory test results and… more
- Randstad (Worcester, MA)
- …requirements and individual expectations. This role serves to administer the appeals and grievance process as outlined in handbooks, departmental policies, and ... standards. This role is responsible for triaging and assigning all incoming appeals and grievances and will also provide administrative support to the department.… more
- Forrest General Hospital (Hattiesburg, MS)
- …and private insurance companies. Tracks and trends all denials and appeals by DRG, physicians, and payers and provides proactive measures and strategies to ... The Denials Management Coordinator performs comprehensive review and management of insurance claims denials. Review, manage, and resolve denied claims related to… more
- Children's Law Center (Brooklyn, NY)
- …Parts of the Supreme Court of the State of New York, and in appeals therefrom. CLC represents approximately 5,000 children annually in the Bronx, Brooklyn, Queens, ... attorney who will be part of the Writing and Appeals team with an additional focus on advancing children's...Regularly and appropriately respond to court, client, community, and staff concerns, and maintain professional and ethical standards at… more
- City Of Concordia (Concordia, KS)
- … liaison for the Planning Commission and the Board of Zoning Appeals preparing staff reports, providing required/requested information, and providing resultant ... reports to the City Commission as needed. Functions as staff liaison for the Board of Building Trades, preparing...required. Attendance at Planning Commission and Board of Zoning Appeals meetings may be required. JOB QUALIFICATIONS Ability to… more
- City of Torrance, CA (Torrance, CA)
- …of Torrance by conducting legal research, handling a variety of motions and appeals , and conducting misdemeanor trials. Legal Counselors report to a Deputy City ... from Monday through Friday, 7:30 am to 5:30 pm, closed on alternate Fridays. Staff is also required to work some off Fridays, evenings, weekends, and holidays, as… more
- American Recruiting and Consulting Group (Jacksonville, FL)
- …Medicare program. * Provide clinical consultation to internal teams (eg, medical review staff , appeals teams) and external stakeholders. * Provide the clinical ... the practitioner/provider/supplier/beneficiary community. * Provide direction and assistance to clinical staff in conducting provider education, as well as assist in… more
- Woundlocal (Austin, TX)
- …to the medical team, ensure timely submission to payers, review claim denials, submit appeals , and bill secondary insurance . All claims are made for advanced ... and coding for accurate claims processing. Evaluate and re-file appeals of patient claims that were denied. Stay up-to-date...delivery service. We provide lunch every Friday to the staff . Benefits: Health insurance Free telehealth visits… more
- Renville County (Olivia, MN)
- …benefits under the GI Bill, vocational rehabilitation, home loans, and life insurance . Advise and assist veterans, their dependents, and survivors in exploring, ... burial in a national cemetery, burial allowances, grave markers, government life insurance , and survivor benefits. Ensure all deadlines are met and maintain… more
- City of Compton, CA (Compton, CA)
- …repair of commercial, residential and industrial properties, and permitting staff and operations; and performs other related duties. SUPERVISION RECEIVED/EXERCISED ... training, motivation and evaluation of Department personnel, provides or coordinates staff training, including safety training; works with employees to correct… more
- State of Colorado (Littleton, CO)
- …join our team. We are committed to increasing the diversity of our staff and providing culturally responsive programs and services. Therefore, we encourage responses ... of notice or acknowledgment of the department's action. For more information about the appeals process, the official appeal form, and how to deliver it to the State… more
- PHI Health (Phoenix, AZ)
- …PHI payer and facility contracts. Demonstrates, performs an understanding of insurance collections to include payment in full (negotiation) offers, overpayment ... reviews and approvals, next action on correspondence, insurance types, insurance classes, in compliance with...Draft correspondence to patients and payers including 1st level appeals for technical denials, and identify accounts to refer… more
- CNY Family Care LLP (Syracuse, NY)
- …first of the month following your date of hire. Practice paid life insurance . Full complement of voluntary benefits. $1,000 annual employer contribution to HSA if ... a busy primary care office. Closely coordinate with clinical staff and providers to ensure that all information is...accurately documented in the medical record and that all insurance -required criteria are met for medication approval. Secure prior… more
- CPa Medical Billing (East Haven, CT)
- …system for that patient and promptly re-bill. Contact guarantors as needed to determine insurance coverage. Drop tickets having no insurance to self-pay and bill ... days on hold for that payer if dollars exist. Appeals : Initiate appeals to payers following the...tickets with action taken and paste any proof of insurance eligibility. Be prepared to account for action taken… more
- State of Colorado (Canon City, CO)
- …and dental health plans; Short and long term disability coverage; Paid life insurance ; 11 paid holidays per year plus vacation and sick leave; Wellness program, ... assessments, and clinical interventions. Serves as consultant for unit staff regarding assessment, diagnosis, and treatment planning. Provides clinical direction… more
