- 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
- Humana (Denver, CO)
- …caring community and help us put health first** The Grievances & Appeals Representative 4 Investigates and resolves member and practitioner issues. manages client ... if an a grievance, appeal or further request is warranted. The Grievances & Appeals Representative 4 + Review documents + Building cases + Inventory Management +… 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 ... + Medical utilization management experience + Working with health insurance organizations, hospitals and other healthcare providers, patient interaction, etc.… more
- Highmark Health (Denver, CO)
- …could be a result of internal/external audits, member/provider phone calls, other insurance information received, appeals , and system changes, etc.; provides ... times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of… more
- Cardinal Health (Denver, CO)
- …level customer service + Experience conducting and documenting patient health insurance benefit investigations, prior authorizations, and appeals , preferred + ... the patient and/or program + Conducts benefits investigations to identify patients' insurance plan coverage for medications, procedures, and travel and lodging +… more
- State of Colorado (Denver, CO)
- …, Dental (https://dhr.colorado.gov/state-employees/state-employee-benefits/dental- insurance ) , and ... coverage + Automatic Short-Term and Optional Long-Term Disability Coverage (https://dhr.colorado.gov/state-employees/state-employee-benefits/disability- insurance ) + Life and AD&D Insurance +… 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 ...of Choice! Benefits You Expect: + AFLAC Supplemental Medical Insurance + Basic Term Life & Optional Term Life… more
- Affordable Care (Colorado Springs, CO)
- …skills. Experience working with Dentrix, handling dental office finances, full insurance billing process (including claims submission, appeals , and denial ... job well. **Additional benefits include** , group medical and dental insurance , vision insurance , life insurance , flexible spending (health and dependent… 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
- CVS Health (Denver, CO)
- …**Quality Appeal Coordinator** coordinates reviews and evaluations for complaints and appeals received by the organization. This includes denied claims, coverage ... and independently coaches others on matters regarding complaints and appeals . **In this role, you will:** + Handle quality...experience working with claims. + Prior experience in health insurance . + Prior experience in compliance or auditing. +… more