- 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)
- **Overview** **About us:** Fallon Health is a company that cares. We prioritize our members-always-making sure they get the care they need and deserve. Founded in ... purpose** : Responsible for the coordination and timely completion of provider appeals . Serves as a liaison between Fallon Health and contracted and non-contracted… 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 ... report and recommend solutions. Research incoming Medicare Fast Track appeals to identify if appropriate for unit based upon...Track appeal is handled within established timeframe to meet company and regulatory requirements. Act as single point of… 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 ... 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
- 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...Dental, Vision and Prescription Drug Plans + 401(K) with company match and discounted stock plan + SoFi Student… 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
- CVS Health (Hartford, CT)
- …make health care more personal, convenient and affordable. Position Summary Aetna, a CVS Health Company , a Fortune 6 company , is one of the oldest and largest ... of this Medical Director role are related to Medicare Appeals .* Direct daily work on part C appeals...This position also includes an award target in the company 's equity award program. In addition to your compensation,… more
- Universal Health Services (Richmond, VA)
- …Companies. Our operating philosophy is as effective today as it was upon the Company 's founding in 1979: Build or acquire high quality hospitals in rapidly growing ... Atlantic Region CBO is seeking a dynamic and talented Appeals Specialist. The Appeals Specialist is responsible...Dental, Vision and Prescription Drug Plan 401k plan with company match + Generous Paid Time Off If you… more
- HCA Healthcare (Brentwood, TN)
- …work environment where diversity and inclusion thrive? Submit your application for our Appeals Specialist opening with Parallon today and find out what it truly ... benefits may vary by location._** We are seeking a Appeals Specialist for our team to ensure that we...an equal opportunity employer and value diversity at our company . We do not discriminate on the basis of… 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...an equal opportunity employer and value diversity at our company . We do not discriminate on the basis of… 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...contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information. (C)… more
- Elevance Health (Rancho Cordova, CA)
- **Nurse Appeals - Licensed RN Nurse** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live in the state of California ... Monday to Friday from 8:00-5:00 pm PT The **Nurse Appeals ** is responsible for investigating and processing and medical...a number of legitimate, non-discriminatory factors set by the company . The company is fully committed to… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- …Role Brighton Health Plan Solutions (BHPS) is seeking an experienced Appeals Coordinator skilled in investigating and resolving grievances, provider payment disputes ... and medical appeals submitted by our members and providers. Responsible for...networks, and innovative technology platform. As a healthcare enablement company , we unlock opportunities that provide clients with the… more
- Kepro (Indianapolis, IN)
- …Health. Think of it as an open invitation to embrace the mission of the company , to actively engage in problem-solving, and to take ownership of your work every day. ... sector. Acentra is currently looking for a Utilization Management Appeals Nurse - LPN/RN to join our growing team....commutable distance of Indianapolis, Indiana. ** Some travel, at company expense, to Indianapolis, Indiana, may be required to… more
- HCA Healthcare (San Antonio, TX)
- …environment where diversity and inclusion thrive? Submit your application for our Senior Appeals Analyst opening with Parallon today and find out what it truly means ... may vary by location._** We are seeking a Senior Appeals Analyst for our team to ensure that we...discrepancies to leadership as appropriate You will identify payer company trends and communicate them to the supervisor for… more
- Lincoln Financial Group (Columbus, OH)
- …#:** 73054 **The Role at a Glance** We are excited to bring on an Appeals Specialist to join our Appeal Review Department in a fully remote environment. Appeal ... conduct reviews, investigation, and analysis of an assigned caseload of Long-Term Disability appeals and Life Waiver of Premium claims. The role is responsible for… more
- Elevance Health (Rancho Cordova, CA)
- **Manager II Grievance/ Appeals - Claims Support** **Location: *CA Residential Requirement** This position will work a hybrid model (remote and office). Ideal ... within 50 miles of one of our PulsePoint locations. The **Manager II Grievance/ Appeals ** is responsible for management oversight of grievances and appeals … more
- CVS Health (Hartford, CT)
- …are Monday-Friday 8a-5p in time zone of residence. Position Summary The Appeals Nurse Consultant position is responsible for processing the medical necessity of ... Medicare Part C appeals from both members and providers. This role is...into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and… more
- Brighton Health Plan Solutions, LLC (Westbury, NY)
- About The Role The Appeals Manager is responsible managing Appeal Supervisors and identifying opportunities for enhancements and changes to workflows to increase ... + Effectively manage Appeal Supervisors, providing full-time support to appeals , internal departments, vendors, and customers. + Demonstrate strong leadership… more