- Evolent (Denver, CO)
- …Stay for the culture. **What You'll Be Doing:** Job Description The Specialty Appeals Team offers candidates the opportunity to make a meaningful impact as part ... of a highly trained dedicated team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent… more
- CVS Health (Denver, CO)
- …focus primarily on review appeal cases for denied medical services. This includes First Level Appeals / Second Level Appeals / Expedited Appeals / Appeal ... Hearings / Special Projects and Committee participation when needed. The Medical Director will provide clinical, coding, and reimbursement expertise as well as directing case management when necessary. The Medical Director will act as a business and clinical… more
- Humana (Denver, CO)
- …Director (CMD) relies on medical background to review health claims and preservice appeals . The Corporate Medical Director works on problems of diverse scope and ... complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions regarding the appropriateness and medical necessity of services provided by other healthcare professionals in compliance with coverage… more
- Humana (Denver, CO)
- …Medical Director relies on medical background and reviews health claims and preservice appeals . The Corporate Medical Director works on problems of diverse scope and ... complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the appropriateness of services provided by other healthcare professionals in compliance with review policies, procedures, and… more
- Adams County Government (Brighton, CO)
- …The Deputy District Attorney performs professional legal work in the litigation of appeals in the Adams and Broomfield District Courts, Colorado Court of Appeals ... of Duties for Success + Litigates misdemeanor and traffic appeals arising from County Court cases and felony ...appeals arising from County Court cases and felony appeals from District Court cases. + Reviews court records… more
- State of Colorado (Pueblo, CO)
- …progressive discipline; records management; recruitment; responding to grievances, appeals , charges of discrimination; reorganization issues; retention; selection ... and selection appeals ; settlement advice; strategic planning and overall HR guidance...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (Denver, CO)
- …of consume r protection and state antitrust laws, prosecution of criminal appeals and certain complex white-collar crimes, training and certification of peace ... of civil rights violations, fair housing, and workers' rights. + Criminal Appeals Section: Represents the state when defendants challenge felony convictions in the… more
- State of Colorado (Denver, CO)
- …+ Child and Adult Mistreatment Dispute Review Section: + Child abuse and neglect appeals + Adult mistreatment appeals Description of Job HYBRID; Minimum of 2 ... of notice or acknowledgement of the department's action. For more information about the appeals process, the official appeal form, and how to deliver it to the State… more
- CenterWell (Denver, CO)
- …to, managing and monitoring all payer requests for additional documentation (ADR), appeals and denials. Works with branch staff to gather required information and ... collaborates with branch and billing staff to determine appropriate response, manages appeals process. + Monitors and responds to all requests related to revenue… more
- State of Colorado (Denver, CO)
- …of notice or acknowledgment of the department's action. For more information about the appeals process, the official appeal form, and how to deliver it to the State ... Rules and Personnel Director's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, at spb.colorado.gov under Rules. A standard appeal form… more