- Henry Ford Health System (West Bloomfield, MI)
- …case scheduling inEPIC, knowledge of medical coding, and familiarity with insurance authorization and appeals processes. Strong organizational skills, ... insurance appeal letters. + Monitor and follow up on appeals with insurance companies. + Own and maintain themaster schedule templatefor the Neurosurgery… more
- Sanford Health (Sioux Falls, SD)
- …oversight and operational management of the organization's member and provider appeals , complaints, and grievance processes across all product lines, including ACA, ... ensures adherence to all state, federal, CMS, HHS, and quality regulations governing appeals and grievance resolution. Lead and manage the end-to-end appeals and… more
- AmeriHealth Caritas (Philadelphia, PA)
- …about us at www.amerihealthcaritas.com. **Responsibilities:** Reporting to the Supervisor, Appeals and Grievances, this position is responsible for the ... administrative tasks for coordination of member and/or provider appeals , the analysis of claims and appeals ,...Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day… more
- Centene Corporation (Sacramento, CA)
- …Hills or Natomas offices **Position Purpose:** Ensure appropriate processing of member grievance appeals , provider appeals , or request for a State Fair Hearing. ... with the State. Manage the day to day responsibilities of the Grievance & Appeals Coordinators. + Ensure that the Grievance and Appeals department processes all… more
- Martin's Point Health Care (Portland, ME)
- …been certified as a "Great Place to Work" since 2015. Position Summary The Appeals Quality and Training Specialist supports the Appeals Department. This role ... quality monitoring and training. This role partners directly with Appeals leadership to support on-going team development and growth....Experience + 3+ years of experience in the health insurance field. + Proven experience and success in a… more
- LA Care Health Plan (Los Angeles, CA)
- Registered Nurse (RN) Manager, Appeals and Grievances General Operations (Clinical) Job Category: Clinical Department: CSC Appeals & Grievances Location: Los ... the safety net required to achieve that purpose. Job Summary The Manager, Appeals & Grievances (A&G) & General Operations (Clinical) is responsible for the daily… more
- Catholic Health Services (Melville, NY)
- …advisors and facility departments. + Develops/validates daily work lists for Utilization and Appeals Manager. + Assist with all insurance and regulatory audits ... Island's Top Workplace! Job Details Position Summary: The Utilization and Appeals Coordinator will perform activities to help facilitate utilization management and… more
- Evolent (Montpelier, VT)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Specialty Appeals Team offers candidates the opportunity to make a meaningful impact as part of ... a highly trained dedicated team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …supervision of the Director of Patient Financial Services, the Clinical Appeals Specialist performs advanced level work related to clinical denial management. ... conducting a comprehensive review of relevant clinical documentation. The Clinical Appeals Specialist will write compelling arguments based on clinical documentation… more
- MTA (Brooklyn, NY)
- Assistant General Counsel III - Appeals , Torts Job ID: 12066 Business Unit: New York City Transit Location: Brooklyn, NY, United States Regular/Temporary: Regular ... Posted: Jul 10, 2025 Description Job Information Assistant General Counsel III - Appeals , Torts First Date of Posting: 7/10/2025 Last Date of Filing: Until Filled… more