- 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
- Centene Corporation (Salem, OR)
- …strongly preferred RN or LPN with utilization review, case management, and appeals experience in a managed care setting is strongly preferred **Position Purpose:** ... Act as the liaison for all statewide appeals , fair hearings, review organizations, and other external type appeals . Responsible for ensuring that all appeal… more
- Centene Corporation (Raleigh, NC)
- …Must Reside in North Carolina **2+ years of healthcare grievance or appeals , claims, managed care experience, or relevant experience.** **Position Purpose:** Analyze ... and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members. + Gather, analyze and report… more
- Ophthalmic Consultants of Boston (Waltham, MA)
- …medical claims, denials, and self-pay collections + Managing prior authorizations and insurance appeals with a solutions-focused mindset + Hiring, training, and ... Deep understanding of coding standards (ICD-10, CPT, HCPCS) and insurance processes + Proficiency with EHR and PM systems...executive teams Perks & Benefits: + Health & Dental Insurance - effective day one + Paid Time Off… more
- Robert Half Accountemps (Ontario, CA)
- Description We are looking for a detail-oriented Clinical Appeals Reviewer to join our team in Ontario, California. In this role, you will be responsible for ... coordinating and managing documentation related to clinical appeals , ensuring compliance with health plan timelines. This is...offering an excellent opportunity to contribute to the health insurance industry. 90% remote. May require the odd trip… more
- Elevance Health (Atlanta, GA)
- …employment based sponsorship. **Responsible for management oversight of grievances and appeals departmental units to investigate, resolve, and respond to grievances ... and appeals , manages inventory and production levels, and operational and...term disability benefits, 401(k) +match, stock purchase plan, life insurance , wellness programs and financial education resources, to name… more
- Elevance Health (Atlanta, GA)
- **Nurse Appeals ** **Hybrid 1:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing ... unless an accommodation is granted as required by law._ The **Nurse Appeals ** is responsible for investigating and processing and medical necessity appeals… more
- Novant Health (Asheville, NC)
- …records with efficiency and accuracy. + Coordinate peer-to-peer reviews and complete insurance appeals in a timely manner. + Deliver consistent, high-quality ... patient receives exceptional support. What You'll Do: + Serve as a insurance authorizations specialist. + Act as a Dimensions (Epic) super-user, supporting practice… more
- McLaren Health Care (Grand Blanc, MI)
- **Position Summary:** Responsible for coordinating the appeals process for third party payer denials, primarily RAC-related activities and commercial appeals ... Appeal letters will include compelling factual argument and submit to insurance payer requesting timely payment for services. 3. Utilizes pre-existing criteria… more
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