• Clinical Appeals Coordinator

    Centene Corporation (Salem, OR)
    …analyze and report verbal and written information regarding member and provider clinical appeals , including information follow up + Prepare response letters ... for member and provider clinical appeals and ensure letters are compliant with State and NCQA standards. + Maintain files and logs for all appeals +… more
    Centene Corporation (07/16/25)
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  • Data Coordinator , Government Audits…

    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 ... Working for this leading academic medical center means collaboration with top clinical , technical and business professionals across all disciplines. Today at Penn… more
    Penn Medicine (08/07/25)
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  • Insurance Appeals Coordinator

    Munson Healthcare (Traverse City, MI)
    …and initiating the authorization process. 10. Identifies and facilitates appeal responses, gathers clinical packets for appeals , and follows up on appeals ... experience in a revenue cycle role (billing, registration, insurance verification, referral coordinator , etc) . Ability to work independently and problem solve with… more
    Munson Healthcare (07/20/25)
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  • Grievance & Appeals Coordinator I

    Centene Corporation (Phoenix, AZ)
    …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... **Position Purpose:** Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members.… more
    Centene Corporation (08/08/25)
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  • Grievance & Appeals Coordinator II

    Centene Corporation (Phoenix, AZ)
    …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... Purpose:** Analyze and resolve verbal and written claims and authorization grievance/ appeals from providers and members. Resolve all State inquires related to… more
    Centene Corporation (07/29/25)
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  • Appeals and Grievance Specialist

    Commonwealth Care Alliance (Boston, MA)
    …, operations, pharmacy, dental, reporting, and member services. + Supports the Senior Appeals & Grievance Coordinator and A/G Coordinator in day-to-day ... 011540 CCA- Appeals & Grievances **Position Summary** Appeals ...strict deadlines. + When necessary collaborate with care teams, clinical staff, family members, and other involved in providing… more
    Commonwealth Care Alliance (05/21/25)
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  • Grievance & Appeals Specialist

    Robert Half Accountemps (Los Angeles, CA)
    …guidelines for use by examiners or Participant Services Representatives. * Assist Appeals Coordinator with the preparation of Benefits Committee appeal cases. ... IPA Group in Los Angeles is in the immediate need of a Grievance & Appeals Specialist. The Grievance & Appeals Specialist, will be in responsible for… more
    Robert Half Accountemps (07/20/25)
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  • Clinical Support Coordinator

    Squirrel Hill Health Center (Pittsburgh, PA)
    …Health Center (SHHC), is a Federally Qualified Health Center (FQHC), seeking a dedicated Clinical Support Coordinator to join our team. ​The ideal candidate will ... and insurance companies to streamline the authorization process. The Clinical Support Coordinator will assist SHHC Providers...of approval or denial statuses, including next steps for appeals if necessary. ​ + Documentation: ​ + Accurately… more
    Squirrel Hill Health Center (07/10/25)
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  • Pharmacy Clinical Coordinator (Prior…

    CareOregon (Portland, OR)
    …Utah, Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin. Job Title Pharmacy Clinical Coordinator - (Prior Authorization) - Contingent Exemption Status Exempt ... use reviews. + Review medication prior authorization requests and appeals . + Develop and implement clinical educational...requests and appeals . + Develop and implement clinical educational programs to improve drug utilization and quality.… more
    CareOregon (07/12/25)
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  • Managed Care Coordinator

    Elderwood (Cheektowaga, NY)
    …handles Third Party appeals , peer to peers as applicable and with clinical oversight provided by the LPN/RN MDS Coordinator . Attends team meetings at ... Salary $18.50 - $23.07/Hour Overview Managed Care Coordinator Overview The Managed Care Coordinator assists and supports the LPN/RN MDS Coordinator with case… more
    Elderwood (07/04/25)
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