- CHRISTUS Health (Alamogordo, NM)
- …Medicare Conditions of Participation, DNV standards, HIPAA, and reporting requirements. Submits appeals in a timely manner, upon request by the Director. Initiates ... discharge planning on assigned patients within 24 hours of admission. Revises discharge planning as indicated by changes in the patient's condition and circumstances. Arranges for the post-discharge needs of patients. Clearly and accurately documents all… more
- State of Colorado (Denver, CO)
- Appeals Officer Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4512564) Apply Appeals Officer Salary $91,272.00 - $146,040.00 Annually ... information, go to https://www.colorado.gov/pacific/dhr/student-loan-forgiveness-programs . https://dhr.colorado.gov/dhr-resources/student-loan-forgiveness-programs The Office of Appeals issues Final Agency Decisions for Medicaid recipient … more
- Trinity Health (Farmington Hills, MI)
- …Position (Pay Range: $39.8218-$59.7327) Applies clinical and comprehensive payer and appeals knowledge in reviewing all post-billed denials (inclusive of clinical ... of claim escalations. Responsible for leveraging clinical and broad payer and appeals knowledge, and standard procedures to track appeals through first,… more
- ManpowerGroup (Durham, NC)
- **Title:** **Clinical Appeals Analyst** **Location: 4613 University Drive Durham NC 27707 United States (Onsite)** **Duration: 6+ months** **Pay rate: $41.75/hr (On ... W2)** **Job Description:** The Clinical Appeals Consultant is responsible for supporting the increased workload...claims. This role involves providing clinical consultation within the Appeals Department, managing the appeals process to… more
- Martin's Point Health Care (Portland, ME)
- …Place to Work" since 2015. Position Summary Job Description Position Summary: The Appeals Specialist (Medicare or US Family Health Plan) is responsible for ensuring ... coordination and professional handling of all member appeals , non-participating provider preservice and post-service appeals , and participating provider… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Customer Solution Center Appeals and Grievances Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, ... required to achieve that purpose. Job Summary The Supervisor, Customer Solution Center Appeals & Grievances is responsible for direct supervision and support of the… 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
- 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 school + ... details A trusted client of Randstad's has openings for experienced Grievance and Appeals Coordinators. Must be experienced with grievance and appeals , claim… more
- Point32Health (Canton, MA)
- …. **Job Summary** Under the general direction of the VP, the Appeals and Grievances Director is responsible for management and oversight of the ... Enterprise Member Appeals and Grievances Department. The Director is responsible for...Director is responsible for all aspects of the member appeals and grievance processes for all lines of business… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Insurance Appeals Associate Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is the region's top-performing ... timely follow-up with regard to clinical and medical necessity insurance appeals . Analyzes all correspondence regarding insurance denials for the Revenue Integrity… 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...billing of claims and the follow-up on the clinical appeals performed by the facilities. Key Responsibilities include: +… more
- Motion Recruitment Partners (Durham, NC)
- Clinical Appeals Analyst Durham, NC **100% Remote** Contract $35/hr - $39/hr Our client, a nationally recognized and award-winning company in the health insurance ... a possible contract to hire opening for a Clinical Appeals Analyst. They have over 4 million customers and...3 years of clinical LPN, PT, or OT. + Appeals Experience is required **Desired Skills & Experience** +… more
- Magellan Health Services (San Diego, CA)
- Coordinates appeals process as assigned, attends to risk management issues associated with case management and processes appeal requests. In some cases may be ... medical necessity reviews. + Enters all data related to appeals and case reviews into a database. + Prepares...into a database. + Prepares and presents information on appeals to panels second-level multi-disciplinary committee. + Participates in… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, ... required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve member… 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
- LA Care Health Plan (Los Angeles, CA)
- Manager, Customer Solution Center Appeals and Grievances Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 ... to achieve that purpose. Job Summary The Manager, Customer Solution Center Appeals and Grievances is responsible for the centralized intake, logging and triage… more
- HCA Healthcare (Nashville, TN)
- …Do you want to join an organization that invests in you as an Appeals Specialist? At Parallon, you come first. HCA Healthcare has committed up to $300 ... make a difference. We are looking for a dedicated Appeals Specialist like you to be a part of...of our team. **Job Summary and Qualifications** Seeking an Appeals Specialist, who will be responsible for performing end-to-end… more
- Motion Recruitment Partners (Durham, NC)
- Appeals Analyst Durham, NC **100% Remote** Contract $15/hr - $19/hr Our client, a nationally recognized and award-winning company in the health insurance vertical, ... has a possible contract to hire opening for a Appeals Analyst. They have over 4 million customers and...of experience in related field. + Healthcare Experience in Appeals /Claims **Desired Skills & Experience** + Experience with Behavioral… more
- Motion Recruitment Partners (Durham, NC)
- Appeals Coordinator Durham, NC **100% Remote** Contract $15/hr - $15/hr Our client, a nationally recognized and award-winning company in the health insurance ... has a possible contract to hire opening for a Appeals Coordinator. They have over 4 million customers and...+ Performs initial research and documentation of all incoming appeals and, grievances. Demonstrates the ability to research benefits,… 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 benefits,… more
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