- State of Colorado (Denver, CO)
- …of consume r protection and state antitrust laws, prosecution of criminal appeals and certain complex white-collar crimes, training and certification of peace ... of civil rights violations, fair housing, and workers' rights. + Criminal Appeals Section: Represents the state when defendants challenge felony convictions in the… more
- State of Massachusetts (Boston, MA)
- …public facing policy making, promulgating regulations, and rendering final decisions of appeals to the Full Commission from decisions issued by MCAD hearing ... approval and promulgation of regulations, guidelines, and public-facing policy * * Appeals of Investigative Dismissals*: Decide appeals of investigative… more
- Baystate Health (Springfield, MA)
- …the direction of the Receivables Supervisor and Lead; identifies denials/ appeals , makes appropriate system changes, completes balance adjustments, initiates ... write-offs, updates account registration/ insurance information, documents work-in-process, obtains materials to complete the collection and/or appeals process… more
- Fallon Health (Worcester, MA)
- …we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for ... Facebook, Twitter and LinkedIn. **Brief summary of purpose:** The Fallon Health Appeals and Grievance process is an essential function to Fallon Health's compliance… more
- J&J Family of Companies (Pittsburgh, PA)
- …payers to gather all necessary information related to case/patient information, insurance coverage,prior authorization (PA)and appeals processing. + Efficiently ... and analyze patient benefits in coordination with internal program operations, insurance providers, and specialty pharmacy liaisons. + Work independently to complete… more
- Elevance Health (Indianapolis, IN)
- …a BA/BS and minimum of 2 years related experience preferably in healthcare insurance departments such as Grievance and Appeals , Contracting or Claim Operations, ... and facility claims to detect fraudulent, abusive or wasteful healthcare insurance payments to providers and subscribers + Preparation of statistical/financial… more
- Houston Methodist (Katy, TX)
- …of Revenue Cycle, to include but not limited to: medical coding, insurance billing, collections, patient account resolution, appeals /denials, customer service, ... aged accounts, adjudications timeframes, and erroneous denials. + Ensures that insurance follow-up and billing efforts result in optimal reimbursement. Gathers and… more
- TEKsystems (Honolulu, HI)
- …critical analysis of highly complex and sensitive member and provider appeals , inquiries and grievances and applies internal policies and procedures, contractual ... standard, business change, etc. affecting the member advocacy and/or appeals process. At direction of management, assists in the...- Pre-tax and Roth post-tax contributions available * Life Insurance (Voluntary Life & AD&D for the employee and… more
- Penn Medicine (Plainsboro, NJ)
- …obtain insurance authorization of persons served and assist in the filing of appeals in cases of insurance denials. 32. Supervises Social Work students from ... affiliated universities, upon request. 33. Participates in performance improvement, in-services, supervision, department, team, and committee meetings as assigned. 34. Adheres to NASW standards and ethics at all times. 35. Serves as consultant and resource to… more
- Henry Ford Health System (Detroit, MI)
- …education of pediatric residents and medical students. . Provide documentation that meets insurance and regulatory requirements; assist in appeals as needed. . ... - from primary and preventative care to complex and specialty care, health insurance , a full suite of home health offerings, virtual care, pharmacy, eye care… more