- State of Massachusetts (Boston, MA)
- …in health insurance mandates and managed care practices. * Manage staff working in Pharmacy Benefit Manager Oversight by developing goals, delegating tasks, ... *_About the Organization:_* The Division of Insurance ("DOI"), an Agency within the Office of...consumers, employers or health care providers. * Collaborate with staff from the Health Policy Commission to oversee the… more
- Adecco US, Inc. (Washington, DC)
- …specific drug (including Benefit Investigation, Prior Authorization, Claims Assistance, and Appeals ) and educating the office on Payer landscape and services ... met. FRM will frequently interact via telephone with providers and internal staff to arrange site visits, Manufacturer trainings, and educational training venues.… more
- Children's Hospital Boston (Boston, MA)
- …to government/payer regulation and department policy/procedures. + Prepares and submits accurate insurance claims and appeals to payer within required timeframes ... training. Key Responsibilities: + Reviews and verifies all demographic and insurance information utilizing available technologies, payer websites, or by phone… more
- 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
- State of Colorado (Rio Grande County, CO)
- …Attends in-house and off-site educational training, cornerstone online training and staff meetings to maintain current on techniques, policies adequate inter-shift ... of the department's action. For more information about the appeals process, the official appeal form, and how to...+ Employer supplemented Health Savings Account + Paid life insurance + Short- and long-term disability coverage + 11… more
- Manulife (AZ)
- …research projects pertaining to risk assessment. + Process formal underwriting appeals and complaints. + Review underwriting fraud referrals for appropriateness and ... professional image and serve as an example to junior staff . + Manage all aspects of underwriting process for...more junior colleagues and management. + Process formal underwriting appeals and complaints. + Manage underwriting fraud referrals for… more
- Insight Global (Pleasanton, CA)
- …front desk, eligibility staff , and clinical providers to ensure accurate patient insurance data. * Educate staff on Medicare requirements as needed. * Assist ... accounts and resolve payment discrepancies. * Identify underpayments and coordinate appeals or resubmissions. * Maintain current knowledge of CMS and Medicare… more
- Elevance Health (Morristown, NJ)
- …Operations Medical Director** is responsible for supporting the medical management staff ensuring timely and consistent medical decisions to members and providers. ... treatment regimens. + As necessary, assist pre-certification nurses and other staff in understanding the principles behind appropriate utilization of covered… more
- State of Colorado (Golden, CO)
- …designs, detailed plans, and project specifications. + Review work performed by CDOT staff as well as work performed by consultant engineers and technicians to ... + Ability to partner with professionals, consultants, vendors, stakeholders, and staff , with sensitivity to their needs and priorities; + Experience negotiating… more
- US Courts (Washington, DC)
- Summary About the Court The United States Court of Appeals for the Federal Circuit (CAFC) is unique among the thirteen Circuit Courts of Appeal. It has nationwide ... public website. Responsibilities Position Overview The US Court of Appeals for the Federal Circuit is seeking an Information...Manager. The incumbent provides technical support to judges, chambers staff , and court staff in the areas… more
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