- R1 RCM (Salt Lake City, UT)
- …analytics, AI, intelligent automation, and workflow orchestration. As our **Clinical Coding Appeals Nurse** , you will help review and interpret medical records to ... draft appeals of denied and underpaid claims. Every day you...what you will experience working as a Clinical Coding Appeals Nurse:** + Review and interpret medical records to… more
- Molina Healthcare (Austin, TX)
- …systems and other available resources. + Assures timeliness and appropriateness of appeals according to state and federal and Molina Healthcare guidelines. + ... Determines appropriate language for letters and prepare responses to appeals and grievances. + Elevates appropriate appeals ...to appeals and grievances. + Elevates appropriate appeals to the Appeals Specialist. + Generates… more
- Elevance Health (Durham, NC)
- **Medical Director-Pain Management/Anesthesia Appeals ** **Location:** This role enables associates to work virtually full-time, with the exception of required ... as required by law. The **Medical Director Pain Management/Anesthesia Appeals ** is responsible for the review of appeals... Appeals ** is responsible for the review of appeals for physical health medical services, to ensure the… more
- Munson Healthcare (Traverse City, MI)
- …of Utilization Management and works closely with the Utilization Management and Appeals team . Interacts independently with all Munson Health Care departments. ... 6. Monitors and sorts incoming communication to the Utilization Management and Appeals department, including faxes, emails, physical mail, and phone calls. Maintains… more
- State of Massachusetts (Springfield, MA)
- …PROVIDE A RESUME AND COVER LETTER WHEN APPLYING* *Assistant District Attorney: Appeals Unit - Hampden District Attorney's Office* The Hampden District Attorney's ... for the position of Assistant District Attorney in the Appeals Unit. The candidate should have superior research and...complex and high-profile appellate cases in the SJC and Appeals Court; Research, draft, file, and argue post-conviction matters… more
- TEKsystems (Addison, TX)
- …and Epic to investigate claim histories and denial patterns. 2. Rebilling & Appeals Submission + Draft compelling appeal letters, make outbound calls to determine ... & Escalation + Conduct in-depth follow-up on previously submitted appeals . + Analyze denial letters to determine next steps,...+ Other duties as assigned + 3-5 years of appeals RCM preferred in TPO company 23-25/hour based on… more
- Northwell Health (Melville, NY)
- …current state, federal, and third-party payer regulations. Ensures clinical reviews and appeals are up to date and accurately reflect patient's severity of illness ... Skills 3-5 years experience in Utilization Review, Case Management, and Clinical Appeals . 3-5 years of acute inpatient clinical experience. Experience with MCG… more
- Elevance Health (Walnut Creek, CA)
- **Behavioral Health Medical Director-Psychiatrist Appeals ** **Location:** California. This role enables associates to work virtually full-time, with the exception of ... a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US military base, vessel or any… more
- BJC HealthCare (St. Louis, MO)
- …Role** BJC HealthCare is seeking a Patient Accounts Analyst to join our clinical appeals team! In this role, you will be analyzing trends for insurance appeals ... and denials as well as participating in provider huddles. **Overview** **BJC HealthCare** is one of the largest nonprofit health care organizations in the United States, delivering services to residents primarily in the greater St. Louis, southern Illinois… more
- City of New York (New York, NY)
- …experienced attorney (3+ years) to handle post-conviction litigation, including direct appeals , motion responses, and federal writs of habeas corpus. JOB ... effectively in oral and written format Brief and argue a substantial caseload of appeals before the state and federal courts All other duties as assigned ASSISTANT… more
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