- Sanford Health (Sioux Falls, SD)
- …for Nursing Education Accreditation (NLN CNEA). One (1) year experience required in appeals , medical necessity, or prior authorization process. If a graduate of ... interpretation of policies, and handling of correspondence related to denials and appeals submitted by providers and members. Must administer benefits in accordance… more
- Elevance Health (Denver, CO)
- …up is performed. + Collaborates with other departments to assist in obtaining prior authorizations/ appeals . + Document insurance company interactions and all ... PM The **Authorization Representative II** is responsible for the administration of prior authorizations requests for patients whose health plan requires drug … more
- CVS Health (Austin, TX)
- …system Subject Matter Expert to provide support for the Medical Prior Authorization/ Appeals Operational teams. Primary responsibilities include: Lead projects ... Required Qualifications - 4 plus years work experience in Prior Authorizations and/ or Appeals activities preferred....work experience in Prior Authorizations and/ or Appeals activities preferred. - Proficiency with Excel, Word, and… more
- Sutherland Global Services (Columbus, OH)
- …Requests + Authorizations + Status Inquiries + Denial Rationale + Utilization Management Appeals + Prior Authorization Verification + Eligibility and Benefits + ... with claims and claims investigations + Status Inquiries + Denial Rationale + Appeals + Research and Routing + Explanation of Payments / Explanation of Benefits… more
- Health Advocates Network (Folsom, CA)
- …(2) years of Professional Billing with an emphasis on Managed Care denial follow-up and appeals processing - prior hospital billing experience is a plus. + 3-5 ... and resolving claim denials, ADR requests, and certs, submitting and tracking appeals , noting trends, and providing monthly reports. Respond to audit requests… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Insurance Appeals Associate Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is the region's top-performing ... timely follow-up with regard to clinical and medical necessity insurance appeals . Analyzes all correspondence regarding insurance denials for the Revenue Integrity… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Insurance Appeals Associate Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is the region's top-performing ... || ### Responsibilities + Analyze denials and coordinates insurance appeals . + Recognizes situations which necessitate supervision and guidance, seeks… more
- Iowa Department of Administrative Services (Des Moines, IA)
- Assistant Attorney General- Criminal Appeals Section Print (https://www.governmentjobs.com/careers/iowa/jobs/newprint/4519255) Assistant Attorney General- Criminal ... Appeals Section Salary $57,636.80 - $139,318.40 Annually Location Des...judicial clerk, a member of a law review, or prior appellate practice. This position requires a license, or… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Quality Auditing Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los ... required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Quality Auditing (QA) Specialist II is responsible for assisting… more
- CVS Health (Hartford, CT)
- …or 9-6 in designated time zone) with occasional weekends and holidays. The Appeals Nurse Consultant position is responsible for processing the medical necessity of ... Medicare Part C appeals from both members and providers. This role is...required to have received at least one COVID-19 shot prior to your first day of employment and to… more