- BroadPath Healthcare Solutions (Tucson, AZ)
- **Overview** BroadPath is seeking a highly motivated and results-driven **UM RN Appeals Coordinator .** This role collaborates with clinical review staff, medical ... to ensure consistent clinical evaluation and processing of medical necessity appeals . Accurate documentation and detailed recordkeeping of notifications to members… more
- Jobleads-US (Chicago, IL)
- …and reviews common errors or misses with physicians and leadership. The Billing Coordinator reflects the mission, vision, and values of NM, adheres to the ... guidelines and all other regulatory and accreditation standards. The Billing Coordinator is responsible for processing charges, payments and/or adjustments for all… more
- Florida Atlantic University (Boca Raton, FL)
- …employee account. Position Summary: Florida Atlantic University is seeking a Coordinator , Student Financial Aid - Boca Raton, FL. Responsibilities: + Responsible ... includes processing of awards, revision requests, satisfactory academic progress appeals , counselor reports, and professional judgments. + Occasionally attend… more
- Jobleads-US (Miami, FL)
- …of CPT, ICD-10, charge entry, and claims management processes. Knowledge of appeals process and researching denials as applicable to business needs. Possesses ... effective verbal and written communication skills. Knowledge of Microsoft Systems Word, Excel, Power Point and Access is a must. Must be detail-oriented team player with excellent written and communication skills. Background in coding experience in other… more
- Catholic Health Services (Melville, NY)
- …Long Island's Top Workplace! Job Details Position Summary: The Utilization and Appeals Coordinator will perform activities to help facilitate utilization ... management and appeals functions to include coordination of specific process and payment related activities. Position Responsibilities: + Prepares necessary… more
- Motion Recruitment Partners (Birmingham, AL)
- Claims Appeals and Grievance Coordinator Birmingham, Alabama **Onsite** Contract $18/hr - $28/hr Are you detail-oriented, highly organized, and passionate about ... making a difference in healthcare? We are seeking several Appeals and Grievances Coordinators for an onsite contract opportunity in Birmingham, AL. In this role,… more
- Centene Corporation (Salem, OR)
- …RN or LPN** **Oregon state license **Utilization review, case management, and appeals experience in a managed care setting is strongly preferred** **Position ... Purpose:** Act as the liaison for all statewide appeals , fair hearings, review organizations, and other external type appeals . Responsible for ensuring that all… more
- Nuvance Health (Danbury, CT)
- …Provides high quality administrative support to Clinical Denial Prevention & Appeals Specialist RNs, Physician Advisors (PAs) and other stakeholders in ensuring ... role is instrumental in liaising with all above parties to submit provider appeals to insurance companies including Medicare and Medicaid for the Nuvance Health… more
- AmeriHealth Caritas (Philadelphia, PA)
- …about us at www.amerihealthcaritas.com. **Responsibilities:** Reporting to the Supervisor, Appeals and Grievances, this position is responsible for the ... administrative tasks for coordination of member and/or provider appeals , the analysis of claims and appeals ,...provider appeals , the analysis of claims and appeals , and the review of medical management authorizations.; +… more
- CVS Health (Carson City, NV)
- …9am-1pm.** Responsible for Oversight of that that investigates and resolution of appeals scenarios for all products, which may contain multiple issues and, may ... responses from multiple business units. Ensure timely, customer focused response to appeals . Identify trends and emerging issues and report and recommend solutions.… more
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