- Axelon Services Corporation (Highland Beach, FL)
- …appropriate discharge plan, care plan, and coordination of acute care and long term care services * Assist member with filing and resolving complaints and appeals ... This position is member facing Job Description: Position Purpose: Responsible for members gaining access to needed services through coordination and integration of medical and long term care services for the purpose of orientation, care plan development,… more
- Accounting Now (Pinellas Park, FL)
- …companies on unpaid insurance accounts identified through aging reportsAble to identify an appeals worthy claim and or ability to process appeals online or ... provider meetings/ workshops when neededCommunicate with billing and credentialing coordinator to identify and resolve audit review issuesAnswer/respond to… more
- Staffing Now (Manassas, VA)
- …questions and complaints, interfaces with third-party administrators to resolve claim appeals .Works with employees to promote health and wellness in the workplace; ... Resources.Performs payroll processing in the absence of the Payroll Coordinator .Other duties as assigned.Education and Experience:Bachelor's degree or equivalent… 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
- Randstad US (Woodland Hills, CA)
- grievance and appeals coordinator . + woodland hills , california + posted may 8, 2024 **job details** summary + $19.99 - $22 per hour + temp to perm + high ... details A trusted client of Randstad's has openings for experienced Grievance and Appeals Coordinators. Must be experienced with grievance and appeals , claim… more
- Robert Half Accountemps (Durham, NC)
- …Half is seeking out candidates in with outstanding customer service skills for a Appeals Coordinator position with one of its Fortune 500 healthcare clients. The ... Appeals Coordinator will: + Performs initial research and documentation of all incoming appeals and, grievances. + Demonstrates the ability to research… more
- TEKsystems (Houston, TX)
- Hiring For Grievance & Appeals Coordinator ! 100% REMOTE - Texas Note: Candidates from Texas can only apply! Candidates who are having 5+yrs of experience in ... What previous job titles or background work well in this role? * Appeals Coordinator / Case Manager * Medical Biller or Medical Coder * Claims processor… more
- Centers Plan for Healthy Living (Staten Island, NY)
- Grievance and Appeals Coordinator 75 Vanderbilt Ave, Staten Island, NY 10304, USA Req #660 Friday, May 3, 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
- Randstad US (Los Angeles, CA)
- grievance and appeals coordinator (ca residents). + los angeles , california (remote) + posted april 26, 2024 **job details** summary + $21.99 - $22 per hour + ... occupations + referenceAB_4523235 job details This position requires previous Grievance and Appeals experience. Position is remote but candidates must reside in the… more
- Guthrie (Binghamton, NY)
- Summary The Payor Audits and Appeals Coordinator will be responsible for monitoring timely and accurate. Tracking and follow up of requests for information for ... trending reports and reports reflecting recovery activity relative to requests, responses, appeals , denials and recoupments. The Coordinator will establish and… more
- Fallon Health (Worcester, MA)
- …purpose** : Responsible for the coordination and timely completion of provider appeals . Serves as a liaison between Fallon Health and contracted and non-contracted ... providers with appeals regarding filing limit appeals , claim denials, claim payment, retrospective referrals, administrative inpatient days and other issues for… 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 (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
- 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
- University of Virginia (Charlottesville, VA)
- Coordinates complex appeals for denied claims and retro authorization appeals . Coordinates with third party vendors for additional appeal support. Provides ... appeals support for status of accounts that have been...prevent future losses. + Analyzes information required to complete appeals with insurance carriers, service area contacts and workman's… 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 (Phoenix, AZ)
- …Mercy Care lines of business. Required Qualifications -Research incoming electronic disputes/ appeals to identify if appropriate for unit based upon published ... process.-Identify and research all components within member or provider/practitioner complaints/ appeals for all products and services.-Triage incomplete components of… more
- CVS Health (Tallahassee, FL)
- …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 Qualifications1 year experience that includes both HMO and Traditional claim platforms, products, and benefits, patient management, product, compliance and regulatory analysis, special… more
