- Virtua Health (Mount Laurel, NJ)
- …over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques ... appropriate feedback.exit interviews with external auditors, prepares rebuttals and appeals , take appropriate action with responses (including correcting data and… more
- 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 ... necessary collaboration/supervision agreements with Advance Practice Professionals (Certified Registered Nurse Practitioners or Physician Assistants) and provide ongoing supervision.… more
- 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 ... necessary collaboration/supervision agreements with Advance Practice Professionals (Certified Registered Nurse Practitioners or Physician Assistants) and provide ongoing supervision.… more
- BrightSpring Health Services (Lexington, KY)
- …with direct sales and account management experience, a KY or TN State Insurance License (or willingness to quickly get one), and experience working with our ... issues. Refer all unresolved issues to the next level including grievance and appeals . + Actively market plan to new senior care partners within plan Service… more
- Corewell Health (Dearborn, MI)
- …when appropriate. Works collaboratively with departmental, revenue cycle, and clinical appeals staff, physicians, and payers to obtain authorization for care and ... review, home care and/or discharge planning. Preferred + Registered Nurse (RN) - State of Michigan Upon Hire required...more! + Optional identity theft protection, home and auto insurance , pet insurance + Traditional and Roth… more
- Community Health Systems (Franklin, TN)
- …role conducts admission and continued stay reviews, supports denials and appeals activities, and collaborates with healthcare providers to facilitate efficient ... avoidable days, payer communications, and authorization details. + Works with insurance companies to secure coverage approvals and mitigate concurrent denials by… more
- Corewell Health (Royal Oak, MI)
- …when appropriate. Works collaboratively with departmental, revenue cycle, and clinical appeals staff, physicians, and payers to obtain authorization for care and ... review, home care and/or discharge planning. Preferred + Registered Nurse (RN) - State of Michigan License Upon Hire...more! + Optional identity theft protection, home and auto insurance , pet insurance + Traditional and Roth… more
- Arnot Health (Elmira, NY)
- …authorization, untimely filing, coordination of benefits, services type issues, and insurance or service verification. Identify patterns of common denial errors, ... types and recurring issues. 4. Facilitates, coordinates and prepares denial appeals working with internal and external customers in a proactive manner to bring… more
- Cedars-Sinai (Beverly Hills, CA)
- …Hospitals. **Why work here?** Beyond outstanding employee benefits including health and dental insurance , vacation, and a 403(b) we take pride in hiring the best ... Investigates, processes and assists with the resolution of provider grievances and appeals in accordance with contractual requirements and corporate policy. + Begins… more
- CareFirst (Baltimore, MD)
- …authorization of services and approved claims. + Prepares retrospective reviews, case appeals , billing coordination, and clinical support. + Manages the analysis of ... and Abilities (KSAs)** + Proficient in standard medical practices and insurance benefit structures. + Proficient in utilization management processes, standards, and… more