- CareFirst (Baltimore, MD)
- …of the Clinical Medical Claims Review, Medical Underwriting, Medical Policy, Clinical Appeals and Analysis programs and Quality of Care Complaint Unit. May lead ... that week. **ESSENTIAL FUNCTIONS:** + Directs the Medical Review and Appeals units and manages multiple strategic clinical projects that span organizational… more
- 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
- Office of the Secretary of the Interior (Arlington, VA)
- …to the Senior Executive Service (SES). Responsibilities The Director Office of Hearings and Appeals is located in the Office of the Secretary of Interior at the ... management and administrative responsibilities with respect to the hearings and appeals functions of the Department in accordance with existing policies,… more
- Sanford Health (Sioux Falls, SD)
- …interpretation of policies, and handling of correspondence related to denials and appeals submitted by providers and members. Must administer benefits in accordance ... demonstrated understanding of regulatory requirements and timeframes. Intake and coordinate appeals and denials, and then make determinations based on member policy… more
- Abbott (Plano, TX)
- …Our 114,000 colleagues serve people in more than 160 countries. **Sr. Appeals Specialist, Patient Therapy Access Team** **Position Location: 6600 Pinecrest Drive ... **Plano, TX** currently has an opportunity for a **Sr. Appeals Specialist** . This role is responsible for facilitating...in the event of initial coverage denial. Manage complex appeals cases for assigned region including taking ownership of… more
- Penn Medicine (Philadelphia, PA)
- …work? **Summary:** Responsible for coordinating office activities for the Clinical Appeals Coordinators to assist the department in accomplishing the goals and ... also follow expected timelines for Federal and State audits and appeals . **Responsibilities:** + Demonstrates Professionalism within the framework of Relationship… more
- Internal Revenue Service (Fresno, CA)
- …CAREERS? Visit us on the web at www.jobs.irs.gov Responsibilities WHAT IS THE APPEALS DIVISION? A description of the business units can be found at: ... Vacancies will be filled in the following specialty areas: Office of Appeals Case and Operations Support Account and Processing Support Special Programs AARS… more
- Universal Health Services (Bonham, TX)
- …TMC Bonham is managed by Texoma Medical Center, subsidiary of UHS. The Appeals Specialist is responsible for appealing all insurance denials and prepare relevant ... regarding trends in denials. Demonstrate the ability to ensure accurate and timely appeals to third party payers in compliance with Managed Care contracts and… more
- Board of Veterans Appeals (Washington, DC)
- Summary The Board of Veterans' Appeals ' mission is to honor America's promise to its Veterans by timely resolving their appeals under the law. The Board of ... deciding all questions of law and fact resolving Departmental appeals that affect the provision of benefits to Veterans,...recommended by the Chairman of the Board of Veterans' Appeals and appointed by the Secretary of Veterans Affairs,… more
- City of New York (New York, NY)
- …7,500 diverse professionals and knowledgeable experts. The DOC seeks to recruit a Chronic Appeals Analyst to assist with all aspects of the Chronic Appeals Unit ... the following: - Track and process designation of chronic absence and chronic appeals for the Department. - Track and Process all HMD suspensions, medical… more