- Elevance Health (East Syracuse, NY)
- **SCA Appeals Representative I** **Locations:** **PA-Harrisburg, IN-Indianapolis, ME-South Portland, TX-Denison, NY-East Syracuse.** This is a virtual position. The ... $17.25 + South Portland, ME - $17.25 The **SCA Appeals Representative I** position is an entry-level position in...I** position is an entry-level position in the NGS Appeals Department that reviews analyzes and processes non-complex pre-service… 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
- Centene Corporation (New York, NY)
- …license.** **Position Purpose:** Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical ... + Communicates with members, providers, facilities, and other departments regarding appeals requests + Generates appropriate appeals resolution communication and… more
- Guthrie (Binghamton, NY)
- Summary The Payor Audits and Appeals Coordinator will be responsible for monitoring timely and accurate. Tracking and follow up of requests for information for all ... Clinic. The Coordinator will also be responsible for timely coordination of appeals and associated deadlines and reconciliation of payments and recoupments. The… more
- Elevance Health (Albany, NY)
- **Title: Grievances & Appeals Risk Analyst I** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles ... of one of our PulsePoint locations. The **Grievances & Appeals Risk Analyst I** will be responsible for responding...with attorneys both internal and external in grievances and appeals regulatory cases. **Minimum Requirements** + HS diploma +… more
- Elevance Health (Albany, NY)
- **Title: Grievances & Appeals Risk Analyst II** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles ... of one of our PulsePoint locations. The **Grievances & Appeals Risk Analyst II** will be responsible for providing...issues as needed. + Attends and represents Grievances & Appeals at appropriate legal proceedings and arbitration hearings under… more
- Lumen (Albany, NY)
- …in partnering closely with the business leadership in Income Tax Audit and Appeals within Lumen? Does working in a fast-paced environment with agility sound ... lead all of our income tax audit defense and appeals . This professional will champion our tax controversy related...uncertain tax positions + Draft and file protests and appeals of proposed assessments or final audit results. +… more
- CDPHP (Albany, NY)
- …share these values and invites you to be a part of that experience. The Appeals Coordinator is responsible for the timely and accurate triaging all appeals , ... information to process their requests within regulatory guidelines. The Appeals Coordinator is also responsible for daily/weekly/monthly department reporting, and… more
- Glens Falls Hospital (Glens Falls, NY)
- …**Allied Health - Health Information Management* **Title:** *Coding Reimbursement Appeals Supervisor - Health Information Management (HIM) * **Location:** *NY-Glens ... Position ensures Glens Falls Hospital submits codes that reflect the acuity of our patient and DRG's that include all MCC's and CC's for reimbursement. In collaboration with Hospital External Review Team (HERT) members, coordinates reviews and responds to… more
- CVS Health (New York, NY)
- …Designs and develops decision models that analyze and evaluate actual and/or potential scenarios and simulate outcomes to facilitate informed decision-making. ... Leverages advanced analytical tools, decision modeling techniques, and data-driven insights to support strategic decision-making, optimize healthcare processes, and improve patient outcomes. Major Responsibilities + Designs and implements decision models that… more