- University of Rochester (Rochester, NY)
- …GENERAL PURPOSE Serves as the patient referral and prior authorization specialist , with oversight of data and compliance to enterprise standards and ... company barriers and tracking all assistance provided. Accountable for planning, execution, appeals and efficient follow through on all aspects of the process which… more
- Henry Ford Health System (Detroit, MI)
- …FDR oversight activities, Quality Management, Care Management, and/or Grievances and Appeals . + Demonstrated experience at a professional level, in an audit ... Professional Coder-Hospital (CPC-H), Certified Professional Coder-Payer (CPC-P), Certified Coding Specialist (CCS), Certified Coding Specialist - Physician Based… more
- UnityPoint Health (Cedar Rapids, IA)
- …40 Hours Per Week + Job ID: 168048 Overview The Utilization Management Specialist in the Behavioral Health Hospital Outpatient Departments serves a key role in ... care, optimal clinical outcomes and patient and provider satisfaction. The UM Specialist provides the Utilization Management function for patients admitted to BH… more
- Robert Half Accountemps (Tucson, AZ)
- …industry focused in Behavioral Health, is in need for a Medical Billing/Claims specialist near downtown Tucson! You will be tasked with managing medical claims and ... and resolve any customer inquiries related to billing and collections * Conduct appeals and authorizations as part of the medical claims process * Ensure compliance… more
- Bristol Myers Squibb (Tampa, FL)
- …for escalation and resolution of Tier 2 queries, plan interpretation and appeals . + Responsible for ensuring internal processes are documented and updated versions ... Workday, ServiceNow, ADP and vendor management. + Certified Employee Benefits Specialist (CEBS) or equivalent Industry designation, preferred. \#LI-Hybrid If you… more
- State of Colorado (Denver, CO)
- …for overtime compensation. Department Contact Information Kelli Dauleh, Talent Acquisition Specialist ~ ###@state.co.us How To Apply Please submit an online ... and Personnel Director's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, at spb.colorado.gov/board-rules . Supplemental Information How to… more
- HCA Healthcare (Blacksburg, VA)
- …actions). Facilitate due process in accordance with the facility's fair hearing and appeals policy as well as legal and regulatory requirements. In accordance with ... credentialing and Cactus experience preferred. CERTIFICATION: Certified Provider Credentialing Specialist (CPCS) preferred. Capital Division (https://hcacapitaldivision.com/) which encompasses 19… more
- Tarleton State University (Stephenville, TX)
- …technology, and office space. + Reporting: Work with the university budget specialist for record keeping and university reporting. Academic Program Development and ... and rigor of classes and programs; mediate departmental processes for student academic appeals . + Recruitment : Work with the Division of Enrollment Management and… more
- Centene Corporation (Jefferson City, MO)
- …Develop and maintain the audit process and tools related to: authorizations, appeals , quality events, and case management in CCMS; interrater reliability related to ... Coordinate auditing outcomes and system maintenance with the Sr. + Clinical Systems Specialist to resolve or enhance clinical systems + Performs other duties as… more
- State of Colorado (Colorado Springs, CO)
- …and Personnel Director's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, at spb.colorado.gov/board-rules . Supplemental Information Please ... the selection process and will be reviewed by a qualified Human Resources Specialist to determine if applicants meet the minimum qualifications for this position.… more