- Houston Methodist (Sugar Land, TX)
- …utilization review activities, and monitoring the clinical denial management and appeals process, as applicable, in collaboration with clinical team partners. This ... for the denials and determines the need for or feasibility of submitting appeals . + Facilitates communication with payors and external case managers by documenting… more
- State of Minnesota (St. Paul, MN)
- …purpose of this position is to perform intake functions for Paid Leave appeals filed by applicants and employers as authorized under Minnesota Statutes, Chapter ... 268B. Paid Leave Legal Analysts will examine incoming appeals for jurisdiction including timeliness, good cause exceptions, and proper parties, analyze the substance… more
- State of Minnesota (St. Paul, MN)
- …Dept / DHS Central Office AFSCME + **Division/Unit** : DHS - Central Office / Appeals Administrative Supv + **Work Shift/Work Hours** : Day Shift, 8:00am - 4:30pm + ... will provide advanced legal and technical support services to appeals activities for state fair hearings and the MNsure...operations of the Division which processes 18,000 to 20,000 appeals each year. The incumbent will accomplish this by… more
- Adams County Government (Brighton, CO)
- …The Deputy District Attorney performs professional legal work in the litigation of appeals in the Adams and Broomfield District Courts, Colorado Court of Appeals ... of Duties for Success + Litigates misdemeanor and traffic appeals arising from County Court cases and felony ...appeals arising from County Court cases and felony appeals from District Court cases. + Reviews court records… more
- State of Colorado (Pueblo, CO)
- …progressive discipline; records management; recruitment; responding to grievances, appeals , charges of discrimination; reorganization issues; retention; selection ... and selection appeals ; settlement advice; strategic planning and overall HR guidance...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- Corewell Health (Southfield, MI)
- …reviews. Coordinates activities involved in the certification, recertification, and concurrent appeals process, conducting referrals for 2nd level review, as needed. ... received by the physician/provider and utilization reviews. Initiates concurrent appeals to address patient class/status downgrades or clinical denials related… more
- UNC Health Care (Chapel Hill, NC)
- …coder questions and provide training and education. This position processes and appeals insurance coding denials. This position analyzes coded records for compliance ... cases). 3. Faxes, tracks, and monitors coding denials and appeals on both inpatient and outpatient cases. Reviews coding...and send for rebilling if required. 5. Generate coding appeals for insurance denials with sound arguments and based… more
- MTA (Brooklyn, NY)
- …needed basis , 1 to 3 days per week serving on the Paratransit Eligibility Appeals Board. The physician will provide medical expertise and support in the review of ... appellants' application and eligibility determination documentation. + Assist the Eligibility Appeals Director with conducting eligibility appeals via telephone,… more
- Montana State University (Bozeman, MT)
- …will perform all customer service duties, coordinate the unit's citation appeals process, and provide administrative support. Performs of customer service functions ... databases and various digital and paper records. + Screen citation appeals for recommendations to the appeals board. + Schedule and conduct monthly appeals … more
- MyFlorida (Tallahassee, FL)
- …the following: Member and Customer Support: + Level II Enrollment and Eligibility Appeals : performs research sufficient to address all issues raised in appeals ; ... witness testimony for administrative hearings related to enrollment and eligibility appeals . + Maintains database/log of enrollment and eligibility appeals ,… more
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