• Appeals Manager

    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
    BronxCare Health System (06/21/25)
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  • Appeals RN - Care Manager *Part-Time…

    Providence (Santa Rosa, CA)
    **Description** Care Manager RN- 100% Remote ( Appeals ) working Part Time Day shift (20 hours per week). Manages specific patients throughout their admission to ... ensure the availability of sufficient clinical and medical center resources. Communicates on a daily basis with medical staff, medical center personnel and outside resources to ensure the appropriate utilization of resources according to clinical and financial… more
    Providence (07/11/25)
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  • Manager , Customer Solution Center…

    LA Care Health Plan (Los Angeles, CA)
    Manager , Customer Solution Center Appeals and Grievances Job Category: Management/Executive Department: CSC Appeals & Grievances Location: Los Angeles, CA, ... net required to achieve that purpose. Job Summary The Manager , Customer Solution Center Appeals and Grievances is responsible for the centralized intake, logging… more
    LA Care Health Plan (07/08/25)
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  • Customer Solution Center Appeals

    LA Care Health Plan (Los Angeles, CA)
    …required by clinical staff to render decisions, assists the Customer Solution Center Appeals & Grievance Manager and Director in meeting regulatory timelines by ... obtaining clarification on initial responses. (25%) Under the supervision of the Appeals and Grievance Manager , assist with soliciting non-clinical information… more
    LA Care Health Plan (07/06/25)
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  • Medicaid Appeals & Grievance Associate…

    CVS Health (Baton Rouge, LA)
    …Summary** Coordinate effective resolution of member and/or provider/practitioner appeals , complaints and grievances. Responsible for the day-to-day management ... of staff to ensure effective resolution of member or provider/practitioner appeals , complaints and grievances for all products, which may contain multiple issues… more
    CVS Health (07/10/25)
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  • IRE Grievance & Appeals Mgr II

    Elevance Health (Durham, NC)
    ** Manager II Grievance/ Appeals ** **- Claims Support** **Office Locations:** _The selected candidate must reside within a reasonable commuting distance of the ... unless an accommodation is granted as required by law._ The ** Manager II Grievance/ Appeals ** responsible for management oversight of grievances and appeals more
    Elevance Health (07/15/25)
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  • Paid Leave Judge - Compensation Attorney - Paid…

    State of Minnesota (St. Paul, MN)
    …join a legal team making a difference for Minnesotans! Reporting to the Paid Leave Appeals Manager , you're key to the overall success of our division. **Key ... + **Division/Unit** : Paid Family & Medical Leave / Appeals Hearings Unit + **Work Shift/Work Hours** : Day...that may be appealed to the Minnesota Court of Appeals . + **Timely Execution of Duties:** Must hold multiple… more
    State of Minnesota (07/03/25)
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  • Paid Leave Judge Principal - Compensation Attorney…

    State of Minnesota (St. Paul, MN)
    …join a legal team making a difference for Minnesotans! Reporting to the Paid Leave Appeals Manager , you're key to the overall success of our division. **Key ... + **Division/Unit** : Paid Family & Medical Leave / Appeals Hearings Unit + **Work Shift/Work Hours** : Day...that may be appealed to the Minnesota Court of Appeals . + **Timely Execution of Duties:** Must hold multiple… more
    State of Minnesota (06/28/25)
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  • Senior CBO Appeals Analyst

    Mount Sinai Health System (New York, NY)
    …issues in an accurate and timely fashion. In collaboration with the Underpayment Team manager , the Senior CBO Appeals Analyst will work to further the CBO's ... **Job Description** The Senior CBO Appeals Analyst position requires an in-depth knowledge of...hospital/healthcare environment is required. Advanced knowledge of Epic, Contract Manager , and Microsoft Excel Working knowledge of other Microsoft… more
    Mount Sinai Health System (05/17/25)
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  • Director Health Plan Operations

    Pacific Medical Centers (Renton, WA)
    …performance tracking systems, and ensure adherence to financial targets. + **Integrity and Appeals Manager :** Oversee the integrity program and appeals ... presentations, and make decisions on post-service, network, and benefit appeals . + **Customer Satisfaction Advocate:** Actively solicit customer feedback, resolve… more
    Pacific Medical Centers (07/16/25)
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