- CVS Health (Sacramento, CA)
- …Summary** 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
- Munson Healthcare (Traverse City, MI)
- …experience in a revenue cycle role (billing, registration, insurance verification, referral coordinator , etc) . Ability to work independently and problem solve with ... of Utilization Management and works closely with the Utilization Management and Appeals team . Interacts independently with all Munson Health Care departments.… more
- Centene Corporation (Phoenix, AZ)
- …**Position Purpose:** Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members. ... verbal and written member and provider complaints, grievances and appeals + Prepare response letters for member and provider...response letters for member and provider complaints, grievances and appeals + Maintain files on individual appeals … more
- CVS Health (Phoenix, AZ)
- …+ Prepares information and reports needed to address matters regarding complaints, appeals , and grievances. + Carries out policies, procedures, and programs to ... compliance with federal and/or state regulations. + Reviews, interprets, and processes appeals and grievances filed by patients, escalating more complex issues and… more
- Sharp HealthCare (San Diego, CA)
- …Will Do** Responsible for the investigation, documentation and resolution of member appeals and grievances in compliance with State law, rules, and guidelines; ... Chief Medical Officer (CMO) who is responsible for all decisions regarding clinical appeals and grievances and the Chief Operations Officer (COO) who is responsible… more
- Sharp HealthCare (San Diego, CA)
- …Do** Responsible for the investigation, documentation and resolution of Commercial member appeals and grievances in compliance with State law, rules, and guidelines; ... Chief Medical Officer (CMO) who is responsible for all decisions regarding clinical appeals and grievances and the Chief Operations Officer (COO) who is responsible… more
- Commonwealth Care Alliance (Boston, MA)
- …clinical, operations, pharmacy, dental, reporting, and member services. + Supports the Senior Appeals & Grievance Coordinator and A/G Coordinator in ... 011540 CCA- Appeals & Grievances **Position Summary** Appeals and Grievances Specialist supports the Operations Department and the Appeals and Grievances team… more
- Penn Medicine (Bala Cynwyd, PA)
- …employees shape our future each day. Are you living your life's work? **Data Coordinator , Government Audits and Appeals ** Job Summary: + The Data Coordinator ... the direction of the Director of Hospital Compliance, Government Audit and Appeals , receives, reviews, and enters data into the audit tracking database according… more
- State of Michigan (Lansing, MI)
- Departmental Technician Hearings & Appeals 7-E9 Print (https://www.governmentjobs.com/careers/michigan/jobs/newprint/5050132) Apply Departmental Technician ... Hearings & Appeals 7-E9 Salary $22.55 - $30.98 Hourly Location Lansing, MI Job Type Permanent Full Time Job Number 6401-25-LCC-019 DT7E9 Department Licensing and… more
- Ellis Medicine (Schenectady, NY)
- …the chart to fax or send for insurance denials or quality improvement organization appeals . + Assists UM Coordinator with data entry of insurance authorizations ... and denials. + Denial Management Activities + Assists Denial Management staff with clerical support; including facilitating MD to MD reviews. + Performs audit activities under the supervision of the Director of Case Management and Social Work Services. Ellis… more