- Centene Corporation (New York, NY)
- …Friday.** **Position Purpose:** Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical ... + Communicates with members, providers, facilities, and other departments regarding appeals requests + Generates appropriate appeals resolution communication and… more
- MTA (Brooklyn, NY)
- Executive Agency Counsel, Appeals Job ID: 12747 Business Unit: MABSTOA Location: Brooklyn, NY, United States Regular/Temporary: Regular Department: Torts Date ... 27, 2025 Description Job Information Executive Agency Counsel, Non-Managerial (Level A & B)- Appeals First Date of Posting: 8/19/2025 Last Date of Posting: Open Until… more
- Akumin (Kissimmee, FL)
- …imaging procedures from insurance companies. Provides supporting documentation for all insurance appeals and denials. + Other duties as assigned. **Position ... Requirements:** + High School Diploma or equivalent experience. + CPR Certification. + 1 year in medical/hospital setting + **Interpersonal Skills:** Relationship building skills to work with all functional units of the organization effectively. Experience in… more
- Humana (Tallahassee, FL)
- …a part of our caring community and help us put health first** The Appeals Representative 4 - IRT (Internal Review Team) Investigates and resolves member and ... documentation to determine if an appeal or further request is warranted. The Appeals Representative 4 IRT (Internal Review Team) + Review documents + Building cases… more
- Cognizant (Phoenix, AZ)
- …. Maintain working knowledge of applicable health insurers' internal claims, appeals , and retro-authorization as well as timely filing deadlines and processes. ... Medicare, Medicaid, and third-party guidelines. . Effectively document and log claims/ appeals information on relevant tracking systems . Utilize critical thinking… more
- CenterWell (Helena, MT)
- …our caring community and help us put health first** The Grievances & Appeals Representative 3 manages client denials and concerns by conducting a comprehensive ... with clinical and other Humana parties. The Grievances & Appeals Representative 3 performs advanced administrative/operational/customer support duties that require… more
- Actalent (Dallas, TX)
- Job Title: Specialist, Appeals & GrievancesJob Summary: Responsible for reviewing and resolving member and provider complaints and communicating resolutions. Key ... Responsibilities: + Conduct comprehensive research and resolve appeals , disputes, grievances, and complaints. + Use internal systems...- Pre-tax and Roth post-tax contributions available * Life Insurance (Voluntary Life & AD&D for the employee and… more
- Elevance Health (Richmond, VA)
- **Medical Director-Dermatology Appeals ** **Location:** 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 **Medical Director-Dermatology Appeals ** is responsible for the review of appeals for physical health… more
- AbbVie (North Chicago, IL)
- …a subject matter expert on commercial pharmacy, major medical, and government insurance plans, prior authorizations, appeals , and alternate coverage referrals. ... LinkedIn and Tik Tok (https://www.tiktok.com/@abbvie) . Job Description The Supervisor, Insurance Analyst provides leadership, support, and supervision for the … more
- Lincoln Financial (Denver, CO)
- …for this opportunity. **Requisition #:** 74565 **The Role at a Glance** As an Appeals Specialist you will be responsible for being a product subject matter expert to ... for multiple product lines. You will perform and deliver on appeals claims assignments/projects while simultaneously leveraging and applying knowledge. You will… more
Recent Jobs
-
Primary Counselor (Addiction) -FT
- Outreach Development Corporation (Richmond Hill, NY)