- Catholic Health Services (Melville, NY)
- …Health was named Long Island's Top Workplace! Job Details The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews and appeals ... and/or escalates denial when appropriate. Submits all (initial and/or appeals ) reviews and/or letters within contractual or regulatory timeframes. Collaborates… more
- BronxCare Health System (Bronx, NY)
- …the analysis and preparation of responses to payor denials and develop strong appeals for the purpose of securing reimbursement for acute care services provided to ... identification of patterns and trends identified during the course of appeals preparation. Conduct departmental performance improvement audits, analyze findings and… more
- LA Care Health Plan (Los Angeles, CA)
- Manager , Customer Solution Center Appeals and Grievances Job Category: Management/Executive Department: CSC Appeals & Grievances Location: Los Angeles, CA, ... net required to achieve that purpose. Job Summary The Manager , Customer Solution Center Appeals and Grievances is responsible for the centralized intake, logging… more
- Public Storage (Plano, TX)
- …and preferred stocks trade on the New York Stock Exchange. **Job Description** The Senior Manager , Property Tax Appeals and Analysis, is a key member of the ... Public Storage tax team, responsible for strategically managing the property tax appeals process across a national portfolio. This position reports directly to the… more
- LA Care Health Plan (Los Angeles, CA)
- …required by clinical staff to render decisions, assists the Customer Solution Center Appeals & Grievance Manager and Director in meeting regulatory timelines by ... obtaining clarification on initial responses. (25%) Under the supervision of the Appeals and Grievance Manager , assist with soliciting non-clinical information… more
- State of Minnesota (St. Paul, MN)
- …join a legal team making a difference for Minnesotans! Reporting to the Paid Leave Appeals Manager , you're key to the overall success of our division. **Key ... + **Division/Unit** : Paid Family & Medical Leave / Appeals Hearings Unit + **Work Shift/Work Hours** : Day...that may be appealed to the Minnesota Court of Appeals . + **Timely Execution of Duties:** Must hold multiple… more
- State of Minnesota (St. Paul, MN)
- …join a legal team making a difference for Minnesotans! Reporting to the Paid Leave Appeals Manager , you're key to the overall success of our division. **Key ... + **Division/Unit** : Paid Family & Medical Leave / Appeals Hearings Unit + **Work Shift/Work Hours** : Day...that may be appealed to the Minnesota Court of Appeals . + **Timely Execution of Duties:** Must hold multiple… more
- Mount Sinai Health System (New York, NY)
- …as per department protocol (IPRO Discharge Appeals / Insurance requests) + Support Appeals Nurse / Manager by confirming status of denials + Tracking status ... + Requests or provides Medical Records as required for appeals , On / Off-site Insurance reviews + Implements.../ Off-site Insurance reviews + Implements first step of appeals process to assist Appeals Nurse and… more
- State of Minnesota (St. Paul, MN)
- …and receiving documents submitted for evidence. This position works within the Paid Leave Appeals unit and works with the Senior Manager of Appeals , ... within the Paid Leave Division of DEED, not limited to, but including, Appeals . The administrative functions include assisting with mailing, making calls to parties,… more
- TEKsystems (Annapolis, MD)
- Description Position Summary The clinical denial appeals specialist is responsible for the identification, mitigation, and prevention of clinical denials. This staff ... reviews all initial clinical denials to determine next steps and conducts appeals as appropriate, such as by reviewing medical necessity, responding to authorization… more