- Evolent (Denver, CO)
- …for the mission. Stay for the culture. **What You'll Be Doing:** 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 and… more
- CenterWell (Denver, CO)
- …data analytics, denial and appeal process. The Director, Home Health Grievances & Appeals assists members, via phone or face to face, further/support quality related ... development/implementation required + Expert knowledge of all Medicare regulations and appeals processes + Excellent analytical skills with ability to interpret and… more
- Humana (Denver, CO)
- …The Medical Director relies on broad clinical expertise to review Medicare drug appeals (Part D & B). The Medical director work assignments involve moderately ... Medical Director's work includes computer based review of moderately complex to complex appeals for coverage for drugs using resources outlined above as well as… more
- Cardinal Health (Denver, CO)
- …maintain optimal account receivables performance and client satisfaction. + Resolves complex insurance claims, including appeals and denials, to ensure timely ... as a subject matter expert in claims processing. + Processes claims: investigates insurance claims; properly resolves by follow-up & disposition. + Lead and manage… more
- State of Colorado (Denver, CO)
- …, Criminal Appeals ,State Services (http://www.coloradoattorneygeneral.gov/departments/state\_services) ... authority for enforcement of consumer protection laws, prosecution of criminal appeals , antitrust laws, and certain natural resource and environmental matters and… more
- State of Colorado (Denver, CO)
- …dental health plans (https://dhr.colorado.gov/state-employees/state-of-colorado-employee-benefits) + Paid life insurance + Short- and long-term disability coverage + ... official appeal form, signed by you or your representative. Appeals to the State Personnel Board or the State...variety of benefits including medical, dental, life and disability insurance , as well as a comprehensive leave program. Please… more
- State of Colorado (Denver, CO)
- …of consumer protection and state antitrust laws, prosecution of criminal appeals and certain complex white-collar crimes, training and certification of peace ... in tort cases, including negotiation and all stages of litigation through appeals . + Work with and assist District Attorneys, managing settlement funds, directing… more
- Humana (Denver, CO)
- …and/or requested site of service should be authorized at the Initial and Appeals /Disputes level. All work occurs within a context of regulatory compliance, and work ... an overview of coding practices and clinical documentation, disputes processes, and appeals processes, and outpatient services and equipment, within their scope. The… more
- State of Colorado (Pueblo, CO)
- …staff members, including direct supervision of 3 individual units: Medicare/Other Insurance , Medicaid/Self- pay, and Audit, including 3 professional staff, 6 ... a witness in estate, bankruptcy settlements, and court hearings regarding claim appeals and debt collection proceedings to ensure the Department gets appropriate… more
- State of Colorado (Denver, CO)
- Bilingual Compensation Insurance Specialist I Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5191435) Apply Bilingual Compensation ... Insurance Specialist I Salary $4,238.00 - $5,127.20 Monthly Location...and Personnel Director's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, at spb.colorado.gov/board-rules . Supplemental Information For… more