- Henry Ford Health System (Troy, MI)
- RN PROVIDER APPEALS COORDINATOR - MEDICAL APPEALS - 40 HOURS WEEKLY - DAY SHIFT Full Time Benefit Eligible Schedule: Monday through Friday, 8:00AM to 4:30PM. ... Alliance Plan (HAP) is looking to grow our Medical Appeals Team with an experienced Registered Nurse! We are...and counting) and Utilization Review Coordinators (4) that review appeals for medical necessity using established medical criteria ,… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Coordinator I(Temp) Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los ... to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Coordinator I supports the Customer Solution Center Appeals &… more
- Munson Healthcare (Traverse City, MI)
- …experience in a revenue cycle role (billing, registration, insurance verification, referral coordinator , etc) . Ability to work independently and problem solve with ... of Utilization Management and works closely with the Utilization Management and Appeals team . Interacts independently with all Munson Health Care departments.… more
- Centene Corporation (Phoenix, AZ)
- …**Position Purpose:** Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members. ... verbal and written member and provider complaints, grievances and appeals + Prepare response letters for member and provider...response letters for member and provider complaints, grievances and appeals + Maintain files on individual appeals … more
- Sharp HealthCare (San Diego, CA)
- …Will Do** Responsible for the investigation, documentation and resolution of member appeals and grievances in compliance with State law, rules, and guidelines; ... Chief Medical Officer (CMO) who is responsible for all decisions regarding clinical appeals and grievances and the Chief Operations Officer (COO) who is responsible… more
- Commonwealth Care Alliance (Boston, MA)
- …clinical, operations, pharmacy, dental, reporting, and member services. + Supports the Senior Appeals & Grievance Coordinator and A/G Coordinator in ... 011540 CCA- Appeals & Grievances **Position Summary** Appeals and Grievances Specialist supports the Operations Department and the Appeals and Grievances team… more
- Penn Medicine (Bala Cynwyd, PA)
- …employees shape our future each day. Are you living your life's work? **Data Coordinator , Government Audits and Appeals ** Job Summary: + The Data Coordinator ... the direction of the Director of Hospital Compliance, Government Audit and Appeals , receives, reviews, and enters data into the audit tracking database according… more
- State of Michigan (Lansing, MI)
- Departmental Specialist 13 - Appeals Review Officer - Legal Affairs Print (https://www.governmentjobs.com/careers/michigan/jobs/newprint/5049167) Apply ... Departmental Specialist 13 - Appeals Review Officer - Legal Affairs Salary $2,484.80 - $3,708.80 Biweekly Location Lansing, MI Job Type Permanent Full Time Job… more
- Ellis Medicine (Schenectady, NY)
- …the chart to fax or send for insurance denials or quality improvement organization appeals . + Assists UM Coordinator with data entry of insurance authorizations ... and denials. + Denial Management Activities + Assists Denial Management staff with clerical support; including facilitating MD to MD reviews. + Performs audit activities under the supervision of the Director of Case Management and Social Work Services. Ellis… more
- City of New York (New York, NY)
- …and Article 78 requests and simultaneously handle post-conviction litigation, including direct appeals , Article 440 motions, and federal writs of habeas corpus. JOB ... made through Office internal request system Make recommendations to Appeals Bureau Chief on viability of such appeals... Appeals Bureau Chief on viability of such appeals and communicate with other bureaus about requests Draft… more
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