- Merck & Co. (Rahway, NJ)
- …and other audit-related documents.Assist in the formal process of administrative appeals as necessary.Manage the amendment of state returns resulting from ... conclusions drawn during Federal audits.Required QualificationsBachelor's degree in accounting, finance, or a related field.A minimum of 4+ years in Tax Audit, Tax Compliance, or Tax Accounting.Experience in preparing Federal Forms, particularly Form… more
- Henry Ford Health System (Troy, MI)
- GENERAL SUMMARY: The Clinical Manager, Provider Appeals supports appeals team members to plan, direct, evaluate, coordinate, and manage the activities associated ... with the Provider Appeals as it relates to key HAP initiatives and...excellence. Ensure the efficient and timely processing of provider appeals , for all product lines (HMO, AHL, and Medicare… more
- AscellaHealth (Berwyn, PA)
- What we are looking for Optime Care seeks a Prior Authorization and Appeals Specialist for our Berwyn, PA location. We are looking for someone who is passionate ... manages the process of receiving, researching, and resolving prior authorizations and appeals issues with health insurance companies, including any escalated step of… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Appeals Specialist II will be responsible for the initial analysis of appeals /grievance correspondence, and ... organizing and tracking information to facilitate and expedite processing of appeals /grievances received from a variety of sources. Responsible for more complicated,… more
- Point32Health (Watertown, MA)
- …(https://www.point32health.org/) . **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Appeals and Grievance Analyst ... the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual works… more
- Elevance Health (Durham, NC)
- **Manager II Grievance/ Appeals ** **- Claims Support** **Office Locations:** _The selected candidate must reside within a reasonable commuting distance of the ... an accommodation is granted as required by law._ The **Manager II Grievance/ Appeals ** responsible for management oversight of grievances and appeals departmental… more
- Fallon Health (Worcester, MA)
- …on Facebook, Twitter and LinkedIn. **Brief summary or purpose:** Fallon Health (FH) Appeals and Grievance process is an essential function to FH's compliance with ... standards, other applicable regulatory requirements and member expectations. The FH Member Appeals and Grievance Intake Administrator serves to administer the FH … more
- Molina Healthcare (St. Petersburg, FL)
- …leading, organizing and directing the activities of the Medicare Duals Grievance and Appeals Unit that is responsible for reviewing and resolving member and provider ... complaints, appeals , and claim disputes, and communicating resolution to members,...direct oversight, monitoring and training of provider disputes and appeals to ensure adherence with Medicare standards and requirements… more
- Molina Healthcare (Des Moines, IA)
- …and directing the activities of the Medicare Contracted Provider Post-Pay Claim Appeals and Disputes in accordance with the standards and requirements established by ... and directs the activities of the Medicare Contracted Provider Post-Pay Claim Appeals and Disputes that is responsible for reviewing and resolving contracted… more
- Commonwealth Care Alliance (Boston, MA)
- 011540 CCA- Appeals & Grievances **Position Summary** Appeals and Grievances Specialist supports the Operations Department and the Appeals and Grievances team ... well as externally to facilitate timely resolution of all grievances and appeals and ensures compliance with regulations. Additionally, this position is responsible… more
