- Banner Health (AZ)
- …innovative employment options by offering remote and hybrid work settings. As a Grievance & Appeals Coordinator , you will be a critical part of the Banner Plans ... **Primary City/State:** Arizona, Arizona **Department Name:** Grievances & Appeals **Work Shift:** Day **Job Category:** General Operations The future is full of… more
- Magellan Health Services (San Diego, CA)
- …ensuring documents meet standards and are accurate. General Job Information Title Appeals Coordinator Grade 19 Work Experience - Required Customer Service ... Coordinates appeals process as assigned, attends to risk management...requests. In some cases may be combined with Grievance Coordinator functions. + Maintains a caseload and monitors day… more
- Centers Plan for Healthy Living (Staten Island, NY)
- Grievance and Appeals Coordinator 75 Vanderbilt Ave, Staten Island, NY 10304, USA Req #660 Wednesday, June 5, 2024 Centers Plan for Healthy Living's goal is to ... SUMMARY: As an integral part of the Grievance and Appeals (G&A) Department, the G&A Coordinator lends their support in processing member-related grievances and … more
- CDPHP (Albany, NY)
- …share these values and invites you to be a part of that experience. The Appeals Coordinator is responsible for the timely and accurate triaging all appeals ... necessary information to process their requests within regulatory guidelines. The Appeals Coordinator is also responsible for daily/weekly/monthly department… more
- Robert Half Legal (Concord, CA)
- …A leading healthcare reimbursement consulting firm is seeking a skilled Paralegal to join their appeals team as an Appeals Coordinator on a contract to hire ... The successful candidate will play a critical role in supporting the appeals process with Medicare's Provider Reimbursement Review Board, ensuring an efficient and… more
- Trinity Health (Darby, PA)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** The Appeals and Utilization Management Coordinator under direction and in collaboration with ... appeals process for the THMA South hospitals. The Appeals and Utilization Management Coordinator ensures the delivery of effective and efficient patient care… more
- Universal Health Services (Chicago, IL)
- …appeal activities for the Utilization Management department, including Expedited Appeals , Standard Appeals , External Independent Reviews, Retrospective Reviews, ... and State Fair Hearings. Review clinical information for all appeals utilizing nationally recognized criteria to determine medical necessity of services requested.… more
- Centene Corporation (Columbus, OH)
- …**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 (IA)
- …state of Iowa. **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 (Tempe, 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
- CVS Health (Columbus, OH)
- …health care more personal, convenient and affordable. Position SummaryCreated grievance and appeals cases in the G&A system and sends acknowledgement letters to ... members and providersRequired QualificationsData Entry SkillsPreferred QualificationsOrganized, ability to multi-task, Detail orientedEducationHigh Scholl Diploma or GED Pay Range The typical pay range for this role is: $17.00 - $28.45 This pay range… more
- Penn Medicine (Philadelphia, PA)
- …Confidentiality, and continuity of communication. + Supports the activities of the Clinical Appeals Coordinator in all phases of the Clinical Quality and ... work? **Summary:** Responsible for coordinating office activities for the Clinical Appeals Coordinators to assist the department in accomplishing the goals and… more
- CVS Health (Carson City, NV)
- …affordable. Position Summary Responsible for managing to resolution of Fast Track Appeals for Medicare products, which may contain multiple issues and, may require ... issues and report and recommend solutions. Research incoming Medicare Fast Track appeals to identify if appropriate for unit based upon published business… more
- CVS Health (Harrisburg, PA)
- …unit. Work in a face paced environment to oversee the resolution of appeals , meeting the internal and external regulatory guidance. Required Qualifications We will ... be looking for candidates with strong communication and organization skills. Preferred Qualifications Experience with Medicare. Education High School Diploma Pay Range The typical pay range for this role is: $17.00 - $28.45 This pay range represents the base… more
- TEKsystems (Tempe, AZ)
- Description: The Account & Appeals Coordinator is a support role, requiring the coordinator to assist the PNOA team by providing basic administrative and ... support functions in the team's day-to-day servicing of clients. The coordinator will participate in special projects as assigned by management and trainings with… more
- Universal Health Services (Richmond, VA)
- …The Atlantic Region CBO is seeking a dynamic and talented Senior Appeals Specialist. The Senior Appeals Specialist is responsible for the ... resolution of all appeals relating to technical issues identified during the billing of claims and the follow-up on the clinical appeals performed by the… more
- District of Columbia Courts (Washington, DC)
- Summary The Appeals Mediation Officer works within the District of Columbia Court of Appeals . As the highest court for the District of Columbia, the Court of ... Appeals is authorized to review all final orders, judgments... Mediation Officer, in consultation with the Mediation Program Coordinator , assists with the execution of mediations conducted under… more
- University of Utah (Salt Lake City, UT)
- …PRN38907B **Job Title** Outpatient/Provider Coder Level 3 **Working Title** Medical Appeals Coding Specialist SR **Job Grade** E **FLSA Code** Nonexempt **Patient ... of revenue cycle. + Working knowledge of insurance denials, appeals and expected reimbursement rates. + Experience presenting findings...its regulations may be referred to the Title IX Coordinator , to the Department of Education, Office for Civil… more
- CVS Health (Harrisburg, PA)
- …personal, convenient and affordable. Position Summary The Medicare Grievance Sr. Coordinator will fully research and resolve beneficiary complaints. Candidates can ... live anywhere US These complaints can include various issues and may require coordination with various departments to fully reach resolution. Responses must be timely and include member focused solutions in both written and oral format. Ideal candidates will… more
- University of Virginia (Charlottesville, VA)
- …coding certification through AAPC. + Other duties as identified by Unit Coordinator , Supervisor and/or Manager. Position Compensation Range: $18.37 - $28.47 Hourly ... **MINIMUM REQUIREMENTS** Education: High School Diploma or GED Experience: Two years relevant office experience required. Experience in insurance field preferred. Experience utilizing EPIC or other medical billing system required. Licensure: CPC required or… more