• Grievances and Appeals Corporate Medical…

    Humana (Frankfort, KY)
    …Qualifications** + Medical management experience, working with health insurance organizations, hospitals and other healthcare providers, patient interaction, ... off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. **About us** Humana Inc. (NYSE: HUM) is… more
    Humana (01/01/26)
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  • Medical Director ( Appeals )

    Health Care Service Corporation (Albuquerque, NM)
    …savings plan, pension plan, paid time off, paid parental leave, disability insurance , supplemental life insurance , employee assistance program, paid holidays, ... tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards . The compensation offered will vary depending on your job-related… more
    Health Care Service Corporation (12/12/25)
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  • Precertification and Authorization…

    Mayo Clinic (Rochester, MN)
    …Prior Auth / Authorization, Cancer Services, Microsoft Office, Radiation Oncology, Insurance Verification, Appeals , and Pre Determination experience preferred. ... for resolving referral, precertification, and/or prior authorization to support insurance specific plan requirements for all commercial, government and other… more
    Mayo Clinic (01/09/26)
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  • Psychiatrist

    KidsPeace Childrens Hospital (Schnecksville, PA)
    …utilization review activities including but not limited to development of standards, insurance company appeals and teleconferences and provision of prior ... related information as requested and needed for medical staff and insurance credentialing and Human Resources employment processes. Qualifications: Minimum includes… more
    KidsPeace Childrens Hospital (01/06/26)
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  • Pediatrician / Family Practice

    KidsPeace Childrens Hospital (Schnecksville, PA)
    …utilization review activities including but not limited to development of standards, insurance company appeals and teleconferences and provision of prior ... manner all related information as requested and needed for medical staff and insurance credentialing and Human Resources employment processes. + All other duties as… more
    KidsPeace Childrens Hospital (01/06/26)
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  • Specialty Financial Clearance Rep

    St. Luke's Health System (Boise, ID)
    …clinical teams, insurance companies and Patient Financial Navigators to address insurance denials and manage appeals . + Educates patients on insurance ... This role ensures that patients receive timely treatment by coordinating with insurance providers, healthcare teams, and Patient Financial Advocates to navigate the… more
    St. Luke's Health System (01/06/26)
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  • CAU Long Term Care Eligibility Specialist

    Louisiana Department of State Civil Service (Baton Rouge, LA)
    …and terminology of legal, medical and business areas, including real estate and insurance . + Trend and analyze appeals data both regionally and statewide. ... Develop and produce reporting based on appeals data to influence training needs and decision making....Minimum two years of professional experience working with Medicaid appeals process. + Minimum two years of professional experience… more
    Louisiana Department of State Civil Service (12/30/25)
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  • FT Patient Care Coordinator - VSG

    Virtua Health (Moorestown, NJ)
    … insurance , billing issues, testing results coordination, as well as pre-certification/ insurance status and appeals .Coordinates the administrative flow of the ... the patient experience including: scheduling of appropriate appointments, documentation, insurance coordination, pre-certifications for testing, follow-up diagnostic testing.Coordination and… more
    Virtua Health (01/05/26)
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  • Case Management Representative - Willowbrook

    Houston Methodist (Houston, TX)
    …etc. on insurance /managed care benefits + Supports and assists with concurrent insurance denials and appeals process, transmission of utilization reviews to ... Two years of experience in any of the following: service recovery, insurance verification, working with patient information, having patient contact, and/or general… more
    Houston Methodist (01/10/26)
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  • Representative II, Accounts Receivable

    Cardinal Health (Doral, FL)
    …queue as assigned in the appropriate system. + Manages and resolves complex insurance claims, including appeals and denials, to ensure timely and accurate ... right things done. **The Accounts Receivable Specialist is responsible for processing insurance claims and billing. They will work within the scope of… more
    Cardinal Health (01/07/26)
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