- Commonwealth Care Alliance (Boston, MA)
- …clinical, operations, pharmacy, dental, reporting, and member services. + Supports the Senior Appeals & Grievance Coordinator and A/G Coordinator in day-to-day ... 011540 CCA- Appeals & Grievances **Position Summary** Appeals and Grievances Specialist supports the Operations Department and the Appeals and Grievances… more
- The County of Los Angeles (Los Angeles, CA)
- …Board Specialist Management Assistant Operation Assistant Personnel Assistant Senior Board Specialist Senior Departmental Personnel Assistant ... Board Specialist Management Assistant Operation Assistant Personnel Assistant Senior Board Specialist Senior Departmental Personnel Assistant… more
- State of Arkansas (AR)
- …for manager, legal and appeals tribunal for hearings. Attend hearings and appeals related to each tax specialist 's 515 account. Research and remove any ... appeals tribunal for hearings. + Attend hearings and appeals related to each tax specialist 's 515...strategies. Present clear and concise tax advisory reports to senior management. Provide training or support to junior personnel… more
- Johns Hopkins University (Middle River, MD)
- …rejections processes to resolve standard issues or escalate to a more senior specialist . **Specific Duties and Responsibilities** _Procedural Knowledge_ + Uses ... file or pull EOB batches. + Identifies and escalates non-standard appeals to a higher-level specialist . + Informs the supervisor / Production Unit Manager of… more
- Johns Hopkins University (Middle River, MD)
- … and rejections processes to resolve standard issues or escalate to a more senior specialist . **Specific Duties & Responsibilities** + Uses A/R follow-up systems ... file or pull EOB batches. + Identifies and escalates non-standard appeals to a higher-level specialist . + Informs the supervisor / Production Unit Manager of… more
- The County of Los Angeles (Los Angeles, CA)
- …Board Specialist Management Assistant Operation Assistant Personnel Assistant Senior Board Specialist Senior Departmental Personnel Assistant ... Accountant I Accountant II Administrative Assistant I Administrative Assistant I, SC Appeals Hearing Specialist Board Specialist Employment Services… more
- Molina Healthcare (AZ)
- …Member issues in areas involving member impact and engagement including: Appeals and Grievances, Member Problem Research and Resolution, and the ... analyses of advocacy issues; and assists with documentation preparation for appeals , fair hearings or other formal/informal dispute resolution process. * Provides… more
- Houston Methodist (Sugar Land, TX)
- At Houston Methodist, the Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical ... denial management and appeals process, as applicable, in collaboration with clinical team...appropriate, DRG recoupments/downgrades, and denials for no authorization. The Senior Denials Management Specialist position communicates clinical… more
- Independent Health (Buffalo, NY)
- …that fosters growth, innovation and collaboration. **Overview** The Clinical & Coding Specialist - Senior will be responsible for reviewing coding and clinical ... They will aid in training other team members, evaluating appeals , and share audit trends across the team. Expertise...audit tips across the team. The Clinical & Coding Specialist - Senior will support the leadership in Hospital… more
- Staffing Solutions Organization (Albany, NY)
- …workforce, which is a reflection of our clients and the people they serve. ** Senior Healthcare Program Specialist (Level 2 or 3) - Albany, NY** **Division ... the new eligibility system for New York's Complex Medicaid population, and the new appeals management system. The individual will act as a liaison between the DEMI… more