- Mount Sinai Health System (New York, NY)
- …current insurance coverage. 5. Collaborates and participates in the appeals process with all members of the interdisciplinary team. 6. Collaborative ... collaboratively with physicians and managed care companies on concurrent denial appeals e. Communicates clinical information to the payor, as needed, coordinating… more
- Molina Healthcare (Rio Rancho, NM)
- JOB DESCRIPTION **Job Summary** Provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal ... chief medical officer (CMO), for administrative law judge pre-hearings, state insurance commissions, and judicial fair hearings. + Reviews medically appropriate… more
- State of Colorado (Lakewood, CO)
- …of notice or acknowledgement of the department's action. For more information about the appeals process, the official appeal form, and how to deliver it to the State ... and Personnel Director's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, at spb.colorado.gov under Rules. Supplemental Information Equity,… more
- Magellan Health Services (Albuquerque, NM)
- …care. Oversees utilization management and criteria-based reviews of care, clinical appeals regarding medical necessity, and the interaction with claims payment ... to assure integration, oversight, and efficiency of utilization management and appeals processes and for delegated functions. In collaboration with the national… more
- Iowa Department of Administrative Services (Altoona, IA)
- …IA Job Type Full-time Job Number 26-01748 Agency 429 Department of Inspections, Appeals & Licensing - Racing & Gaming Commission Opening Date 01/07/2026 Closing Date ... including: + Robust benefits, including excellent health, dental, life and vision insurance . + Generous paid time off, including vacation, paid holidays, and sick… more
- State of Colorado (Craig, CO)
- …of notice or acknowledgement of the department's action. For more information about the appeals process, the official appeal form, and how to deliver it to the State ... Rules and Personnel Director's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, at spb.colorado.gov under Rules. ADAAA Accommodations CDOT… more
- State of Colorado (Rio Grande County, CO)
- …by the State Personnel Director if your application is eliminated. You will find the appeals process, the official appeal form, and how to deliver it on the State ... and Personnel Director's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, within the Rules (https://spb.colorado.gov/board-rules) webpage. Supplemental… more
- TEKsystems (Tampa, FL)
- …will be on the bill review team specifically working in the backlog of appeals . The Bill Review Analyst position holds accountability for accurate and timely review, ... of bills to include pre-coding accuracy and adjudication of appeals /provider reconsideration requests. Job Type & Location This is...- Pre-tax and Roth post-tax contributions available * Life Insurance (Voluntary Life & AD&D for the employee and… more
- AmeriHealth Caritas (Philadelphia, PA)
- …of business; communicate findings clearly. + Oversee Quality Auditing appeals process: documentation, tracking, decision-making, and resolution guidance. + Develop ... cross-functional initiatives. + Respond professionally to inquiries related to audits, appeals , and special projects. + Maintain audit documentation and records per… more
- Executive Office for US Attorneys and the Office of the US… (Wilmington, DE)
- …such as hearings, oral arguments, and trials, in United States District Court and appeals in the United States Court of Appeals . Criminal Division assignments in ... that includes, in part, paid vacation; sick leave; holidays; telework; life insurance ; health benefits; and participation in the Federal Employees Retirement System.… more
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