- Molina Healthcare (San Antonio, TX)
- …issues in areas involving member/provider impact and engagement including: Appeals and Grievances, Problem Research and Resolution, and the development/maintenance ... a wide variety of inquiries and assistance involving claims, authorizations, appeals , contracting, credentialing and other areas including the most complex issues.… more
- UPMC (Pittsburgh, PA)
- …+ Provide new-hire training to Clinical Auditor/Analysts. Performing administrative appeals /preparing medical necessity appeals for Medical Directors for ... of medical terminology, ICD-10 and CPT-4 coding. Knowledge of health insurance products and various lines of business. Detail-oriented individual with excellent… more
- State of Indiana (Indianapolis, IN)
- …(IBTR): The Indiana Board of Tax Review conducts impartial reviews of appeals about the assessed valuation of tangible property, property tax deductions, property ... determination by an assessing official or a property tax assessment board of appeals . The IBTR also reviews assessment determinations made by the Department of Local… more
- AmeriHealth Caritas (Philadelphia, PA)
- …and regulatory updates. + Manage audit disputes through all levels of appeals . + Collaborate with Service Coordination leadership and training teams to identify ... Minimum 3 years of relevant experience in healthcare, quality assurance, appeals , or grievances. + Previous supervisory experience preferred. + Technical Skills:… more
- City of New York (New York, NY)
- …the Department in hearings before the OATH Hearings Division. Draft and file appeals of OATH Hearings Division decisions and respond to respondents appeals . ... entitled to unmatched benefits such as: oa premium-free health insurance plan that saves employees over $10K annually, per...in the Rules of the New York Court of Appeals (Sections 520.3 or 520.5) or admission to the… more
- Brooklyn Defender Services (Brooklyn, NY)
- …intake through the life of a case in Brooklyn Family Court as well as occasional final appeals with the assistance of the Law and Appeals unit. + Work on an ... seeking family reunification when appropriate. + Represent their clients in interim appeals . + Prepare and argue written motions seeking increased visitation, family… more
- City and County of San Francisco (San Francisco, CA)
- …probation, or driving without a valid license, or driving without insurance will be disqualified. 3. Medical Examination: Prior to appointment, candidates ... Rule 111A.35.1. The standard for the review of such appeals is 'abuse of discretion' or 'no rational basis'...position description, the minimum qualifications and/or the certification rule. Appeals must include a written statement of the item(s)… more
- Surgery Care Affiliates (Boise, ID)
- …401k plan with company match, paid time off, life and disability insurance , and more. Please visit, https://careers.sca.health/why-sca, to learn more about our ... you join our team, they will. Responsibilities JOB KNOWLEDGE Credit Balance & Insurance Resolution: + Resolve patient and insurance account balances (primary,… more
- State of Colorado (Golden, CO)
- …dependents. We also offer short and long-term disability coverage, and life insurance that includes legal resources and discounts. + Eligible employees receive Basic ... Life and AD&D insurance equal to their annual earnings subject to a...Procedures, 4 CCR 801, for more information about the appeals process. The State Personnel Board Rules and Personnel… more
- Robert Half Accountemps (Salem, OR)
- …adhering to industry standards. This position requires expertise in handling insurance claims, payment reconciliations, and patient billing inquiries using advanced ... accuracy using clinical software. * Submit electronic and paper insurance claims promptly to ensure timely payments. * Review...processing. * Follow up on unpaid claims, denials, and appeals to maximize reimbursement. * Post payments and reconcile… more