- Point32Health (MA)
- …(https://www.point32health.org/) . **Job Summary** Under the general direction of the Manager, Appeals and Grievances the Supervisor , Appeals and Grievances ... and provide leadership for the daily operations of the Appeals and Grievances department. The supervisor represents the Appeals and Grievances Department and… more
- Point32Health (MA)
- …(https://www.point32health.org/) . **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Appeals and Grievance ... the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual works… more
- Commonwealth Care Alliance (Boston, MA)
- 011540 CCA- Appeals & Grievances **Position Summary:** Appeals and Grievances Program Advisor monitors and supports the operations and compliance of the ... Appeals and Grievances department through many NCQA and other...Federal and State Regulations. Complete individual summary scorecards for Supervisor feedback. + Track monthly scores on spreadsheet and… more
- Highmark Health (Boston, MA)
- …correspondence inquiries (routine, priority Congressional / Department of Defense), and appeals . Ensures that all processes are compliant with requirements and ... performance standards are consistently met. Responsibilities include: provides supervisor direction, scheduling and support for customer service representatives on… more
- Veterans Affairs, Veterans Health Administration (Brockton, MA)
- …informal complaints of employees and refer others, such as formal grievances and appeals , to the supervisor or an appropriate management official. Articulates ... and communicates to the team the assignment, project, problem to be solved, actionable events, milestones, and/or program issues under review, and deadlines and time frames for completion. Ensures the organizational strategic plan, mission, vision and values… more
- Children's Hospital Boston (Boston, MA)
- 81586BRJob Posting Title: Supervisor , Customer Service & Patient Collections (Shared Serv Ctr)Department:Shared Service ... professional relationships with representatives of payer organizations to facilitate appeals of payer decisions; interpret regulation or policy; gather information… more
- State of Massachusetts (Boston, MA)
- …that align with level-of-care standards and payer requirements. * Coordinate appeals and reconsideration processes with managed care agencies and third-party payors. ... **Job:** **Medical Services* **Organization:** **Department of Public Health* **Title:** *Case Management Supervisor * **Location:** *Massachusetts-Boston-170 Morton Street* **Requisition ID:**… more
- State of Massachusetts (Boston, MA)
- …Records ( Supervisor ), the Division processes and issues determinations on appeals from requestors denied access to government records; responds to questions ... driven environment and will be responsible for providing support to the Supervisor , Staff Attorneys and Division in administering the Massachusetts Public Records… more
- Beth Israel Lahey Health (Burlington, MA)
- …interpret third-party payments, adjustments, and denials. Initiates corrected claims, appeals , and analyzes unresolved third-party and self-pay accounts, initiating ... overpayments, credits, and undistributed balances. Works directly with the Billing Supervisor to resolve complex issues and denials through independent research and… more
- Beth Israel Lahey Health (Burlington, MA)
- …in order to determine appropriate coding and initiate corrected claims and appeals . Duties include hands on coding, documentation review and other coding needs ... for ICD-9, ICD-10. Works directly with the Billing Supervisor and Coding Manager to resolve complex issues and...with the resolution of complex claims issues, denials and appeals . 16. Completes projects and research as assigned. 17.… more