- Catholic Health Services (Melville, NY)
- …Performs extensive data analytics, documents findings and recommendations to meet department and corporate goals. Builds, documents and maintains workflows related to ... all phases of department processes and systems. Able to act as an operations' liaison, collaborating with various entities including payers, clinical, financial and/or operational departments. Duties/Responsibilities: Conducts data analysis with a high degree… more
- Universal Health Services (Richmond, VA)
- …One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of ... achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $14.3 billion in 2023. During the year, UHS was again recognized as one of the World's Most Admired Companies by Fortune; and… more
- The Cigna Group (Nashville, TN)
- **Cigna Medicare Part C Appeals Reviewer: Appeals Processing Analyst** We will depend on you to communicate some of our most critical information to the correct ... individuals regarding Medicare appeals and related issues, implications and decisions. The Case...The Case Management Analyst reports to the Supervisor/Manager of Appeals and will coordinate and perform all appeal related… more
- Merit Systems Protection Board (Atlanta, GA)
- …Atlanta Regional Office - Atlanta, Georgia. The office is responsible for adjudicating appeals filed by Federal employees. The incumbent of this position serves as a ... Specialist responsible for assisting in the processing and adjudication of those appeals , as well as providing administrative support to the office. Responsibilities… more
- MyFlorida (West Palm Beach, FL)
- …Annually Position Summary: We are actively seeking individuals to join our Criminal Appeals Unit who possess a strong passion for legal research, writing, and ... the citizens of Florida. At the Attorney General's Criminal Appeals Division, we foster a culture of collaboration, where...this class. The Work You Will Do: The Criminal Appeals Division of the Florida Attorney General's office is… more
- Social Security Administration (Washington, DC)
- …executive direction and leadership over the day-to-day activities and operations of the Appeals Council and its support staff. In that capacity, the incumbent serves ... operational matters, and adjudicative trends at both the administrative appeals level and the court level. The Appeals... appeals level and the court level. The Appeals Council constitutes the adjudicative head of the Agency… more
- US Tech Solutions (Canton, MA)
- **Job Description:** + Under the general direction of the Member Appeals and Grievance Supervisor the Member Appeals and Grievance Analyst is responsible per ... for the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by company. + This individual works… more
- CVS Health (Fresno, CA)
- …between 9am-1pm. Responsible for Oversight of that that investigates and resolution of appeals scenarios for all products, which may contain multiple issues and, may ... responses from multiple business units. Ensure timely, customer focused response to appeals . Identify trends and emerging issues and report and recommend solutions.… more
- Independent Health (Buffalo, NY)
- …and consistent review and investigation of provider and/or member complaints and/or appeals . The Contractual Reviewer-Senior will be required to rely on their ... collaborate with multiple departments and associates to properly investigate appeals /complaints. The Contractual Reviewer-Senior will also be responsible for… more
- State of Massachusetts (Boston, MA)
- …are able to work, available for work, and looking for a job. The appeals process for unemployment issues is governed by Massachusetts General Laws, Chapter 151A. For ... Review Examiner I will preside over administrative hearings on appeals of claims for agency services or benefits not...agency staff, and performs related work as required. Reviews appeals and, when possible, obtains additional evidence to resolve… more