- US Tech Solutions, Inc. (Columbia, SC)
- …center experience. We do not want any candidates without previous industry experience. . Team is comprised of 17 people and the entire department has 80, close nit ... team environment. Responsibilities: . Responsible for responding to customer...to resolve inquiries. Reviews and adjudicates claims and/or non-medical appeals . Determines whether to return, deny or pay claims… more
- Accounting Now (Pinellas Park, FL)
- …and carrier issues relating to billing and reimbursements. Report findings to Team Lead and/or SupervisorResearch, record findings, and communicates effectively ... and carrier issues relating to billing and reimbursements. Report findings to Team Lead and/or SupervisorResearch, record findings, and communicates effectively… more
- Penske Truck Leasing Co., LP (Reading, PA)
- …have an understanding of operating tax statute. They represent Penske as the leader in the truck industry and must maintain professional and favorable relationships ... or manager with operating tax compliance processes including rendition/return filing, appeals and abatements and refund/bill entry. * Be able to understand… more
- Kepro (Indianapolis, IN)
- …ensure timely and complaint processing. They will be a crucial resource for the Appeals Team , contribute to quality initiatives, and champion continuous care for ... innovate health solutions that deliver maximum value and impact. Lead the Way is our rallying cry at Acentra...Appeals Nurse - LPN/RN to join our growing team . Job Summary: Our Utilization Management Appeals … more
- Alight (TX)
- …and Great Place to Work!** **Do you want to be part of a collaborative Appeals team ?** **Our Story** At Alight, we believe a company's success starts with ... others. It's why we're so driven to connect passion with purpose. Our team 's expertise in human insights and cloud technology gives companies and employees around… more
- Abbott (Plano, TX)
- …Our 114,000 colleagues serve people in more than 160 countries. **Sr. Appeals Specialist, Patient Therapy Access Team ** **Position Location: 6600 Pinecrest ... Abbott is a global healthcare leader that helps people live more fully at...**Plano, TX** currently has an opportunity for a **Sr. Appeals Specialist** . This role is responsible for facilitating… more
- Elevance Health (Cincinnati, OH)
- **Grievance/ Appeals Analyst Lead ** **Must be located...Lead ** is responsible for leading and coaching a team of Grievance & Appeals Analysts in ... and process pre service and post service grievances and appeals requests related to clinical and non clinical services,...work flow and makes assignments to ensure the correct team resource is utilized to achieve accreditation and regulatory… more
- Generac Power Systems (Waukesha, WI)
- …want to be challenged and enjoy a fast-paced, high-performance culture. **Job Summary:** The Appeals and Grievances Specialist is a critical team player who is ... ** Appeals & Grievances Specialist I** **Company** Generac Power...Most importantly, it's an opportunity to join an industry leader . There's never been a better time to work… more
- Trinity Health (Farmington Hills, MI)
- …in behaviors, practices, and decisions. Applying broad knowledge of many payers and appeals types, coordinates and may lead denial management processes (Clinical ... Enterprise Patient Financial Services (EPFS) as part of a team of clinical payment resolution colleagues responsible for identifying...new colleagues and/or as a clinical resource for complex appeals . Supports / lead special projects as… 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
- LA Care Health Plan (Los Angeles, CA)
- …for all business-related questions/issues raised by staff; escalates to appropriate leader / team when necessary. Recommends and implements process improvement ... Supervisor, Appeals and Grievances Clinical Operations RN Job Category:...The position supervises all aspects of running an efficient team , including hiring, supervising, coaching, training, disciplining, and motivating… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Quality Auditing Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los ... required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Quality Auditing (QA) Specialist II is responsible for assisting… more
- CareFirst (Baltimore, MD)
- …Clinical Appeals and Analysis programs and Quality of Care Complaint Unit. May lead our Commercial team and our Government Programs (Medicaid and Medicare) ... and other strategic business partners. We are looking for an experienced people leader in the greater Baltimore metropolitan area who is willing and able to… more
- Trinity Health (Farmington Hills, MI)
- …NPR) of a Patient Business Services (PBS) center. Serves as part of a team of clinical payment resolution colleagues at an assigned PBS location responsible for ... Responsible for leveraging clinical knowledge and standard procedures to track appeals through first, second, and subsequent levels, and ensuring timely filing… more
- Centene Corporation (Phoenix, AZ)
- …and appeal decisions. + Act as subject matter expert regarding grievances and appeals . + Lead Appeals and Grievance Committee **Education/Experience:** ... members as a clinical professional on our Medical Management/Health Services team . Centene is a diversified, national organization offering competitive benefits… more
- TEKsystems (Plano, TX)
- Required: + 2+ years of Insurance follow-up, denials/ appeals experience (Medical A/R) + Hospital/facility collections experience Description: Responsible for A/R, ... Responsible for managing CBO Aging Report properly to insure appeals are followed up timely to prevent past filing...monthly on collections. * Works with others as a team player, as well as supporting staff, and hospital/clinic… more
- Glens Falls Hospital (Glens Falls, NY)
- …MCC's and CC's for reimbursement. In collaboration with Hospital External Review Team (HERT) members, coordinates reviews and responds to internal and external ... Management and/or other Allied Health Profession, plus 3-5 year of lead /supervisory experience Associates Degree with-5-7 years of Inpatient Coding and appeal… more
- Catholic Health Services (Melville, NY)
- …time. We are committed to caring for Long Island. Be a part of our team of healthcare heroes and discover why Catholic Health was named Long Island's Top Workplace! ... plan development and management; contributes to completion of project status reports. Lead meetings with staff and/or leadership to assist in establishing project… more
- Trinity Health (Albany, NY)
- …in A/R due to lack of prior authorizations. + Facilitates communication with care team and providers + Appeals denied authorizations for related services, drugs, ... data, system reports, and analytics, supports the needs of the authorization team . Instrumental in developing and implementing strategies to optimize all aspects of… more
- Transdev (San Francisco, CA)
- …even disposition when dealing with difficult or combative persons. + Ability to lead a team , delegate duties appropriately, and follow-up on project ... Lead Certification Analyst Job Description Division: Paratransit Location:...is to oversee the activities and performance of a team of eligibility Certification Analysts. The Certification Analyst's chief… more
