• Clinical Appeals Representative

    Adecco US, Inc. (Ontario, CA)
    Adecco is assisting a local client recruiting for Clinical Appeals Representative opportunities in Ontario, CA (90% remote). This is an excellent opportunity to ... culture and make an impact in the healthcare industry. If a Clinical Appeals Representative role sounds like something you would be interested in, and you meet… more
    Adecco US, Inc. (08/23/25)
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  • Grievance & Appeals Representative

    Humana (Des Moines, IA)
    …of our caring community and help us put health first** The Grievances & Appeals Representative 3 manages client denials and concerns by conducting a ... with clinical and other Humana parties. The Grievances & Appeals Representative 3 performs advanced administrative/operational/customer support duties… more
    Humana (09/02/25)
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  • Transportation Injury Prevention Manager - Term…

    State of Colorado (Denver, CO)
    …review must be submitted on the official appeal form, signed by you or your representative . Appeals to the State Personnel Board or the State Personnel Director ... must be received or postmarked within the filing period: Appeals shall be filed with the Board no later...### Email filings: dpa_###@state.co.us For more information about the appeals process, the official appeal form, and how to… more
    State of Colorado (08/30/25)
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  • Appeals Referee

    Commonwealth of Pennsylvania (PA)
    Appeals Referee Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/5055524) Apply  Appeals Referee Salary $77,379.00 - $117,497.00 Annually ... of Labor & Industry is excited to welcome an Appeals Referee to our dedicated team in the Hermitage...B. I have experience as a legal or non-legal representative of parties to quasi-judicial administrative hearings conducting direct… more
    Commonwealth of Pennsylvania (09/02/25)
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  • Appeals and Grievance Analyst

    Point32Health (MA)
    …(https://www.point32health.org/) . **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Appeals and Grievance Analyst ... the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual works… more
    Point32Health (08/16/25)
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  • Coord Appeals & Grievances

    AmeriHealth Caritas (Newark, DE)
    …about us at www.amerihealthcaritas.com. **Responsibilities:** Reporting to the Supervisor, Appeals and Grievances, this position is responsible for the ... administrative tasks for coordination of member and/or provider appeals , the analysis of claims and appeals ,... system and documents, all correspondence with a member/participant, representative and/or a provider, related to an appeal or… more
    AmeriHealth Caritas (09/03/25)
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  • Manager, Customer Solution Center Appeals…

    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, US, ... to achieve that purpose. Job Summary The Manager, Customer Solution Center Appeals and Grievances is responsible for the centralized intake, logging and triage… more
    LA Care Health Plan (07/08/25)
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  • Assistant US Attorney (Criminal)

    Executive Office for US Attorneys and the Office of the US… (Newport News, VA)
    …an opportunity to work on their own caseload and handle their own trials and appeals as a representative of the United States. This office is hiring for ... part of a dedicated team helping to prosecute federal criminal cases and prepare appeals in the Major Crimes Unit. This Unit investigates and prosecutes a wide… more
    Executive Office for US Attorneys and the Office of the US Attorneys (08/22/25)
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  • Coding Appeals Specialist

    St. Luke's University Health Network (Allentown, PA)
    …regardless of a patient's ability to pay for health care. The Coding Appeals Specialist retrospectively reviews patient medical records, claims data and coding of ... AMA CPT, are assigned to support the services/treatment rendered. The Coding Appeals Specialist also prepares appeal arguments and/or letters to support and defend… more
    St. Luke's University Health Network (08/18/25)
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  • RN Clinical Review Appeals Specialist

    St. Luke's University Health Network (Allentown, PA)
    …a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all ... determination made by the government or commercial payors, or their auditor representative . + Facilitate clinical chart reviews to assist with supporting assigned… more
    St. Luke's University Health Network (07/08/25)
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