- Evolent (Austin, TX)
- …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
- Elevance Health (Houston, TX)
- …employment based sponsorship. **Responsible for management oversight of grievances and appeals departmental units to investigate, resolve, and respond to grievances ... and appeals , manages inventory and production levels, and operational and...term disability benefits, 401(k) +match, stock purchase plan, life insurance , wellness programs and financial education resources, to name… more
- Humana (Austin, TX)
- …a part of our caring community and help us put health first** The Appeals Representative 4 - IRT (Internal Review Team) Investigates and resolves member and ... documentation to determine if an appeal or further request is warranted. The Appeals Representative 4 IRT (Internal Review Team) + Review documents + Building cases… more
- Cognizant (Austin, TX)
- …. Maintain working knowledge of applicable health insurers' internal claims, appeals , and retro-authorization as well as timely filing deadlines and processes. ... Medicare, Medicaid, and third-party guidelines. . Effectively document and log claims/ appeals information on relevant tracking systems . Utilize critical thinking… more
- CenterWell (Austin, TX)
- …our caring community and help us put health first** The Grievances & Appeals Representative 3 manages client denials and concerns by conducting a comprehensive ... with clinical and other Humana parties. The Grievances & Appeals Representative 3 performs advanced administrative/operational/customer support duties that require… more
- Actalent (Dallas, TX)
- Job Title: Specialist, Appeals & GrievancesJob Summary: Responsible for reviewing and resolving member and provider complaints and communicating resolutions. Key ... Responsibilities: + Conduct comprehensive research and resolve appeals , disputes, grievances, and complaints. + Use internal systems...- Pre-tax and Roth post-tax contributions available * Life Insurance (Voluntary Life & AD&D for the employee and… more
- Elevance Health (Grand Prairie, TX)
- **Medical Director-Dermatology Appeals ** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training ... unless an accommodation is granted as required by law. The **Medical Director-Dermatology Appeals ** is responsible for the review of appeals for physical health… more
- Lincoln Financial (Austin, TX)
- …for this opportunity. **Requisition #:** 74565 **The Role at a Glance** As an Appeals Specialist you will be responsible for being a product subject matter expert to ... for multiple product lines. You will perform and deliver on appeals claims assignments/projects while simultaneously leveraging and applying knowledge. You will… more
- Evolent (Austin, TX)
- …the mission. Stay for the culture. **What You'll Be Doing:** The **Coordinator, Appeals and Grievances** at Evolent is responsible for reviewing and processing case ... rather than phone and fax activities. **Collaboration Opportunities** : The Specialty Appeals Team offers candidates the opportunity to make a meaningful impact as… more
- Elevance Health (Grand Prairie, TX)
- **Behavioral Health Medical Director-Psychiatrist Appeals ** **Location:** This role enables associates to work virtually full-time, with the exception of required ... Saturday rotation, once a month.** The **Behavioral Health Medical Director-Psychiatrist Appeals ** is responsible for the administration of behavioral health medical… more