- Covenant Health Inc. (Knoxville, TN)
- Overview Insurance Appeals Senior , Revenue Integrity and Utilization Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is ... insurance pre-certification required. Licensure Requirements: None. Apply/Share Job Title INSURANCE APPEALS SENIOR ID 4357425 Facility Covenant Health Corporate… more
- Hawaiian Electric (Honolulu, HI)
- …on all aspects of litigation matters from case inception to judgment and appeals . SENIOR ASSOCIATE GENERAL COUNSEL (LITIGATION & REGULATORY) JOB FUNCTION: ... Associate General Counsel or Senior Associate General Counsel (Litigation & Regulatory) -...property damage claims, from case inception to judgment and appeals ; advising officers, managers and employees regarding proposed legislation,… more
- Centene Corporation (Jefferson City, MO)
- …medical directors and supervise MD's responsible for utilization management and appeals functions to ensure members receive medically necessary, evidence-based care ... the enterprise. + Provide medical leadership for all utilization management ( appeals ), pharmacy, case management, disease management, cost containment, and medical… more
- CVS Health (Albany, NY)
- …This person will be responsible for curating, leading, and providing oversight of our proficiency program. This includes planning, executing, and supervising ... departmental projects to ensure they are completed within scope and aligned with organizational objectives. **Functional Components** + Collaborating with account executives to resolve any member or plan sponsor complaints. + Communicates professionally and… more
- Ochsner Health (New Orleans, LA)
- …make a difference at Ochsner Health and discover your future today!** The Appeals Specialist is responsible for managing and resolving insurance claim denials and ... Collaborate with clinical staff and coding teams to obtain necessary documentation for appeals + Track and monitor appeal status, maintaining detailed records in the… more
- Henry Ford Health System (Troy, MI)
- …for the prompt and thorough investigation of medical and pharmacy member appeals and grievances for Health Alliance Plan's (HAP's): Commercial, Medicare Advantage, ... of regulatory requirements from State and Federal agencies and speak before members, senior leaders and other key stakeholders to present appeal cases on an ongoing… more
- Thrive Proactive Health (Virginia Beach, VA)
- …2 - Medical Billing Specialist (Experienced): Take ownership of full claim lifecycles, denials, appeals , and collections. + Level 3 - Senior Billing Specialist / ... learning the ins and outs of insurance billing, denials, appeals , and patient financial support. This position is ideal...Submit and follow up on claims, corrected claims, and appeals . + Denials & A/R Management : Investigate, appeal,… more
- NTT America, Inc. (Plano, TX)
- …adaptable, and forward-thinking organization, apply now. We are currently seeking a Delivery Senior Manager to join our team. NTT DATA is seeking to hire a ... **Medicare Appeals Clinical Leader** to lead service delivery engagements and...recommendations and interpretations of records. + Prepare reports for senior management on appeal trends and compliance status. **Requirements:**… more
- Houston Methodist (Sugar Land, TX)
- At Houston Methodist, the Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical ... denial management and appeals process, as applicable, in collaboration with clinical team partners. This position uses sound clinical judgement in the Utilization… more
- MyFlorida (West Palm Beach, FL)
- SENIOR ASSISTANT ATTORNEY GENERAL-DLA - 41001124 Date: Dec 12, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... 865789 Agency: Office of the Attorney General Working Title: SENIOR ASSISTANT ATTORNEY GENERAL-DLA - 41001124 Pay Plan: SES...in federal district courts, the Eleventh Circuit Court of Appeals , and United States Supreme Court. Capable of handling… more
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