- 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 ... health, while reducing costs. POSITION SUMMARY This position handles member and provider grievances, standard appeals and claim disputes. This position will… 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
- 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 ... candidate will play a critical role in supporting the appeals process with Medicare's Provider Reimbursement Review...put you in the best position to succeed. We provide access to top jobs, competitive compensation and benefits,… 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 ... denials and appeals process for the THMA South hospitals. The Appeals and Utilization Management Coordinator ensures the delivery of effective and… more
- Universal Health Services (Chicago, IL)
- …to determine medical necessity of services requested. Prepare letters for member and provider appeals that did not meet criteria. Gather, analyze, and report ... information regarding member and provider appeals . Maintain files and logs for all appeals . Follow all appeals and retrospective reviews through… more
- Centene Corporation (Columbus, OH)
- …from members. + Gather, analyze and report verbal and written member and provider complaints, grievances and appeals + Prepare response letters for member ... Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances...and provider complaints, grievances and appeals + Maintain files on individual appeals … more
- Centene Corporation (IA)
- …+ Gather, analyze and report verbal and written information regarding member and provider clinical appeals , including information follow up + Prepare response ... letters for member and provider clinical appeals and ensure letters are compliant with State and NCQA standards. + Maintain files and logs for all appeals +… more
- Centene Corporation (Tempe, AZ)
- …from providers and members. Resolve all State inquires related to complaints, grievances and appeals . * Review and process member and provider grievances and ... of complex cases * Serve as liaison between member, provider regulatory agencies and internal staff. Correspond with key...* Act as subject matter expert regarding grievances and appeals . * Lead Appeals and Grievance Committee… 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)
- …resolution response. Responsible for coordination of all components of Fast Track appeals including all required communication to member/ provider for final ... affordable. Position Summary Responsible for managing to resolution of Fast Track Appeals for Medicare products, which may contain multiple issues and, may require… 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
- University of Utah (Salt Lake City, UT)
- Details **Open Date** 06/19/2024 **Requisition Number** PRN38907B **Job Title** Outpatient/ Provider Coder Level 3 **Working Title** Medical Appeals Coding ... assurance processes better assist department's reduction in accounts receivable and provide education to internal team members and department as appropriate.… 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 ... BASIC FUNCTION: The Discharge Planner's primary function is to provide administrative support to the Case Management Department. Responsibilities include maintaining… more
- CVS Health (Fresno, CA)
- …benefit/administrative denial. -Identify and research all components within member or provider /practitioner appeals , complaints and grievance for all products ... between 9am-1pm. Responsible for Oversight of that that investigates and resolution of appeals scenarios for all products, which may contain multiple issues and, may… more
- HCA Healthcare (Asheville, NC)
- …for over sight of the Contract Liaison, HIMS Clerk and Service Delivery, Appeals and Grievance (SDAG) Coordinator . Essential Accountabilities: + Develops and ... patient and the patient's family first, and the really great institutions will provide care with warmth, compassion, and dignity for the individual."- Dr. Thomas… more
- State of Massachusetts (Boston, MA)
- …for issuing non-compliances and termination notices to families. When a family appeals a non-compliance/termination, the NC Coordinator is responsible for ... local housing authorities, non-profit organizations, and development partners to provide affordable housing options, financial assistance, and other support to… more
- Colorado State University (Fort Collins, CO)
- …listservs and faculty/staff/student lists + Maintain forwarding address information + Provide information to the Accounting Manager, Graduate Coordinator and ... Posting Detail Information Working TitleOffice Support Coordinator Position LocationFort Collins, CO 80523 Work LocationPosition is fully in-office/in-person Type of… more
- Hartford HealthCare (Southington, CT)
- …part of Connecticut's most comprehensive healthcare network as a Quality Improvement Coordinator . Hartford HealthCare at Home, the largest provider of homecare ... patient. As part of Hartford HealthCare, we leverage cutting edge technology to provide quality care in our client's home. Most importantly, our employees are… more
- State of Colorado (Denver, CO)
- Data Quality Coordinator - Health Professional III - Colorado Immunization Information System Print ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4527678) Apply Data Quality Coordinator - Health Professional III - Colorado Immunization Information… more
- State of Colorado (Durango, CO)
- Equipment Shop Coordinator (Technician III) - Durango Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4547079) Apply Equipment Shop ... Coordinator (Technician III) - Durango Salary $49,848.00 - $57,324.00...original condition or as subsequently improved, in order to provide safe, economical, and efficient highway transportation to the… more