- HCA Healthcare (Brentwood, TN)
- …each individual is recognized. Submit your application for the opportunity below: Appeals SpecialistParallon **Benefits** Parallon offers a total rewards package that ... plans (accident, critical illness, hospital indemnity), auto and home insurance , identity theft protection, legal counseling, long-term care coverage, moving… more
- BJC HealthCare (St. Louis, MO)
- …experience) **Additional Information About the Role** BJC HealthCare is seeking a Clinical Appeals Specialist to assist with infusion appeals for both government ... Responsible for resolving clinical denials for BJC hospitals and payors. The Clinical Appeals Specialist must be able to multi-task and maintain a high level of… more
- Elevance Health (Indianapolis, IN)
- **Nurse Appeals ** **Location: Indiana** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... unless an accommodation is granted as required by law. The **Nurse Appeals ** is responsible for investigating and processing and medical necessity appeals… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Appeals Specialist I is responsible for the initial analysis of appeals and grievance correspondence, and ... collecting, organizing and tracking information to facilitate and expedite processing of appeals and grievances received from a variety of sources. We are looking… more
- LA Care Health Plan (Los Angeles, CA)
- Lead Customer Solution Center Appeals and Grievances RN Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position ... net required to achieve that purpose. Job Summary The Lead Customer Solution Center Appeals and Grievances RN is responsible for assisting with the development of a… more
- Centene Corporation (Indianapolis, IN)
- …**Position Purpose:** Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members. ... and report verbal and written member and provider complaints, grievances and appeals + Prepare response letters for member and provider complaints, grievances and… more
- Elevance Health (Union, NE)
- **SCA Appeals Representative I** **Location** : This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... Medicare and Medicaid Services to transform federal health programs. The **SCA Appeals Rep I** is Responsible for reviewing, analyzing, and processing non-complex… more
- Molina Healthcare (WI)
- JOB DESCRIPTION **Job Summary** The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals requests are ... reviews of previously denied cases in which a formal appeals request has been made or upon request by...chief medical officer for administrative law judge pre-hearings, state insurance commission, and meet and confers. * Represents Molina… more
- Logan Health (Kalispell, MT)
- … denials processing as applicable to assigned area(s). + Responsible for all insurance appeals and works with appropriate stakeholders to ensure completion as ... and promptly. + Help patients understand billing statements, EOBs, and insurance claims. + Post payments and adjustments accurately, ensuring alignment with… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Appeals & Grievance Liaison Associate Location: Remote Career Area: Customer ... an important expansion of our job family structure within Appeals & Grievances. The position will offer visibility into...package which may include: * Medical, dental, and vision insurance * Life insurance * 401k *… more