- Brighton Health Plan Solutions, LLC (Westbury, NY)
- About The Role The Appeals Manager is responsible managing Appeal Supervisors and identifying opportunities for enhancements and changes to workflows to increase ... + Effectively manage Appeal Supervisors, providing full-time support to appeals , internal departments, vendors, and customers. + Demonstrate strong leadership… more
- LA Care Health Plan (Los Angeles, CA)
- Manager , Customer Solution Center Appeals and Grievances Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, ... net required to achieve that purpose. Job Summary The Manager , Customer Solution Center Appeals and Grievances is responsible for the centralized intake, logging… more
- Covenant Health Inc. (Knoxville, TN)
- …appeals hand-offs, maintaining payer correspondence and claims processing. + Notifies Appeals Supervisor or Revenue Integrity Manager when trends are ... Overview Insurance Appeals Associate Full Time, 80 Hours Per Pay...follow-up with regard to clinical and medical necessity insurance appeals . Analyzes all correspondence regarding insurance denials for the… more
- Covenant Health Inc. (Knoxville, TN)
- …appeals hand-offs, maintaining payer correspondence and claims processing. + Notifies Appeals Supervisor or Revenue Integrity Manager when trends are ... Overview Insurance Appeals Associate Full Time, 80 Hours Per Pay...by the department established policies and procedures under the Manager and Supervisor within the department. It requires knowledge… more
- CVS Health (Richmond, VA)
- …Understanding of current Aetna healthcare systems and products including but not limited to HRP, GPS, ATV, MedCompass, Pharmacy systems, etc.-Experience working in a ... fast paced collaborative team environment while delivering a quality product.Prior management experience preferred but not required Preferred Qualifications Prior management experience preferred but not required Understanding of Complaint and Appeal Policies… more
- Centene Corporation (Austin, TX)
- …on workplace flexibility. **Position Purpose:** Manages the denials and/or appeals , disputes, and reconsiderations process including the drafting and review ... of NCQA and state Medicaid program requirements preferred. Advanced knowledge of appeals process preferred. Pay Range: $72,400.00 - $130,100.00 per year Centene… more
- CVS Health (Harrisburg, PA)
- …make health care more personal, convenient and affordable. Position Summary The Associate Manager will assist in the hiring and managing of the Medicare Complaints ... Team staff. The Associate Manager must possess outstanding people skills, exercise good judgement, and contribute to a team environment. Ability to build positive… more
- Actalent (Sacramento, CA)
- …denial. + The Medi-Cal Appeals and Grievances senior RN will report to the Appeals and Grievances Manager . + In this role, you will perform accurate and ... Description: + The Medi-Cal Member Appeals and Grievances team is responsible for clinically...and Grievances team is responsible for clinically reviewing member appeals and grievances that are the result of either… more
- Universal Health Services (Richmond, VA)
- …The Nurse Auditor Team Lead is responsible for working in conjunction with the Appeals Manager to coordinate the operational activities of the nurse auditor's ... workflow in the Appeals department. Key Responsibilities include: + Completes training of...weekly and monthly reports as assigned. + Assist department manager and assistant director with developing individual and group… more
- Hawaiian Electric (Honolulu, HI)
- …on all aspects of litigation matters from case inception to judgment and appeals . Role: Manager Number of Vacancies:1 Work Schedule:Monday - Friday Work ... available. This position may be filled on Oahu or Kahului, Maui. (Role: Manager ) JOB FUNCTION: Provide in-house legal services, with an emphasis on public utility… more
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