- State of Massachusetts (Boston, MA)
- …regulations, and precedents to formulate legal conclusions concerning eligibility for benefits in dispute . * Review cases prior to and after the hearing to ... Review Examiner I | Department of Family &...workplace * Flexibility and mission-driven issue spotting / problem resolution experience * Ability to write concisely to express… more
- Tenet Healthcare (Detroit, MI)
- …disputes and no authorizations in the case management system Follows the payor dispute processes utilizing secondary medical review , peer to peer and payor ... RN Utilization Review - Case Management - 2506004107 Description :...knowledge base to identify opportunities for improvement and problem resolution , evaluate patient status and health care procedures/techniques, and… more
- Covenant Health Inc. (Knoxville, TN)
- …Summary: This position participates in various functions including the review , correction, submission/resubmission, and/or appeal of rejected, denied, unpaid, or ... the patient, charge entry staff, and office staff in cases of patient dispute of charges billed. Demonstrates good judgment when handling financial discussions with… more
- Covenant Health Inc. (Knoxville, TN)
- …Summary: This position participates in various functions including the review , correction, submission/resubmission, and/or appeal of rejected, denied, unpaid, or ... the patient, charge entry staff, and office staff in cases of patient dispute of charges billed. Demonstrates good judgment when handling financial discussions with… more
- Humana (Raleigh, NC)
- …this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all ... gather additional clinical information or discuss determinations which may require conflict resolution skills. Some roles include an overview of coding practices and… more
- Delek US Holdings (Brentwood, TN)
- …provide practical, solution-oriented guidance **Commercial Contracts & Transactions** + Draft, review , and negotiate a broad portfolio of agreements, including: + ... with internal investigations, audits, and compliance reviews + Advise on dispute prevention, claims management, and early-stage disputes + Manage and coordinate… more
- Fifth Third Bank, NA (Cincinnati, OH)
- …partner). Domestic Collections - Responsible for processing and decisioning fraud check dispute claims . Includes working alerts, dispute cases and inbound ... and reporting risks of all types. ESSENTIAL DUTIES & RESPONSIBILITIES: + Review , analyze, and decision fraud detection system alerts in accordance with the… more
- Samsung SDS America (Plano, TX)
- …and property damages + Provide strategic legal advice to internal clients for the resolution of claims and complaints + Draft, review , and negotiate the full ... the company's SL business. You'll also draft, negotiate, and review complex commercial contracts in the context of global...and customs. Further, you'll provide legal advice for the resolution of logistics claims and mitigate legal risks by… more
- State of Colorado (Denver, CO)
- …technical expertise in state purchasing and contracting to facilitate the timely resolution of vendor and customer claims and disputes, to develop (for assigned ... bid openings and post award conferences, and problem-solving conferences as needed. + Review purchase requests and or Shopping Carts in the SRM System for various… more
- Cardinal Health (Carson City, NV)
- …for the collection of outstanding accounts receivable. This includes dispute research, developing payment plans with customers, and building relationships ... The Coordinator, Collections, is responsible for the timely follow-up and resolution of insurance claims. This role ensures accurate and efficient collection… more