- PedIM Healthcare (Crystal River, FL)
- …claims to payers promptly. Follow up on unpaid or denied claims and handle appeals as needed. Work with patients to address billing inquiries and provide assistance ... This is NOT a remote position. This position reports to the Billing Manager . The schedule is M-F, 8:30AM-5:00PM. Apply today Apply at www.pedimhealthcare.com (click… more
- Molina Healthcare (Houston, TX)
- …* Provides second level behavioral health clinical reviews, peer reviews and appeals . * Supports behavioral health committees for quality compliance. * Implements ... (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of America (CMSA) or other… more
- BronxCare Health System (Bronx, NY)
- Overview The Appeals Manager is responsible to assist in the analysis and preparation of response to denial notification letters that arrive in letter and ... to best respond to all hospital denials notification and documentation efforts. The Appeals Manager will provide timely tracking and trending of all denials and … more
- LA Care Health Plan (Los Angeles, CA)
- Registered Nurse (RN) Manager , Appeals and Grievances General Operations (Clinical) Job Category: Clinical Department: CSC Appeals & Grievances Location: Los ... the safety net required to achieve that purpose. Job Summary The Manager , Appeals & Grievances (A&G) & General Operations (Clinical) is responsible for the… more
- BronxCare Health System (Bronx, NY)
- …the analysis and preparation of responses to payor denials and develop strong appeals for the purpose of securing reimbursement for acute care services provided to ... identification of patterns and trends identified during the course of appeals preparation. Conduct departmental performance improvement audits, analyze findings and… more
- FirstEnergy (Akron, OH)
- …automation or AI where appropriate), strengthen controls and procedures, and handle audits and appeals . The Manager will report to the Director, Tax Planning and ... with FirstEnergy Service Company, a subsidiary of FirstEnergy Corp. The Manager , General Taxes, is responsible for compliance, accounting, forecasting, and planning… more
- Garnet Health (Middletown, NY)
- …for the day to day operation of the CDI department and DRG Denials appeals process. The Manager will develop, implement and evaluate processes, policies and ... Administrator, Coding & Clinical Documentation Improvement and Patient Access, the Manager of Clinical Documentation Integrity (CDI) and DRG Denials is responsible… more
- Hawaiian Electric (Honolulu, HI)
- …working on all aspects of litigation matters from case inception to judgment and appeals . Role: Manager Number of Vacancies: 1 Location: Honolulu - Oahu Hiring ... LEGAL Division at Hawaiian Electric Company has 1 Management vacancy available. (Role: Manager ) This posting seeks to fill at either the Associate General Counsel or… more
- The County of Los Angeles (Los Angeles, CA)
- …quality assessment and assurance monitoring processes; and handle informal complainant appeals . Health Facilities Program Manager , Nursing positions are required ... HEALTH FACILITIES PROGRAM MANAGER , NURSING Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4626091) Apply HEALTH FACILITIES PROGRAM MANAGER… more
- Elevance Health (Mason, OH)
- **Nurse Appeals -Licensed Nurse** **Location** : Ohio, candidates must be residents of Ohio to be considered. **Hybrid 1** : This role requires associates to be ... and is dependent on court hearing schedules. The Nurse Appeals is responsible for investigating and processing and medical...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
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