- Mount Sinai Health System (New York, NY)
- **Job Description** The Senior CBO Appeals Analyst position requires an in-depth knowledge of healthcare pricing/reimbursement processes and procedures including ... and timely fashion. In collaboration with the Underpayment Team manager, the Senior CBO Appeals Analyst will work to further the CBO's goals of enhancing… more
- Elevance Health (Atlanta, GA)
- **Audit & Reimbursement Senior ** _Location:_ This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... Services to transform federal health programs._ The **Audit and Reimbursement Senior ** will support our Medicare Administrative Contract (MAC) with the federal… more
- Commonwealth Care Alliance (Boston, MA)
- …clinical, operations, pharmacy, dental, reporting, and member services. + Supports the Senior Appeals & Grievance Coordinator and A/G Coordinator in day-to-day ... 011540 CCA- Appeals & Grievances **Position Summary** Appeals and Grievances Specialist supports the Operations Department and the Appeals and Grievances team… more
- Molina Healthcare (Davenport, IA)
- …for leading, organizing and directing the activities of the Grievance and Appeals Unit that is responsible for reviewing and resolving member and provider ... research and resolution of the complex or escalated and high dollar appeals , grievances, and/or complaints from Molina members, providers and related outside… more
- Independent Health (Buffalo, NY)
- …timely and consistent review and investigation of provider and/or member complaints and/or appeals . The Contractual Reviewer- Senior will be required to rely on ... to collaborate with multiple departments and associates to properly investigate appeals /complaints. The Contractual Reviewer- Senior will also be responsible for… more
- City of New York (New York, NY)
- …78s Create People's appeals and Article 78s manual Perform other duties of senior Appeals Bureau ADA, including: Represent the People of the State of New ... and Article 78 requests and simultaneously handle post-conviction litigation, including direct appeals , Article 440 motions, and federal writs of habeas corpus. JOB… more
- Trinity Health (Columbus, OH)
- …analysis, audit, provider relations and more. **Position Purpose:** The Appeals and Grievance Coordinator is responsible for the processing and resolution ... of appeals , grievances and disputes from members and providers **What...regular monitoring efforts and reports trending and outliers to senior management. + Responsible for ensuring 5-Star (maximum) ratings… more
- Centene Corporation (Jefferson City, MO)
- …to utilization management + Works with utilization management team and senior management to identify opportunities for process and quality improvements within ... compliance with applicable guidelines, policies, and procedures + Works with the senior management to develop and implement UM policies, procedures, and guidelines… more
- Wells Fargo (Charlotte, NC)
- …consultants to gather data and support valuations, and manage property tax audits and appeals as needed. **Business Licenses** The Senior Manager will manage the ... **About this role:** Wells Fargo is seeking a **Sales and Use Tax Senior Manager** responsible for overseeing all aspects of transaction tax compliance and… more
- University of Colorado (Boulder, CO)
- …questions or concerns. Assists students with problem-solving and campus resources. Advances appeals or grievances to the senior program manager as appropriate. ... at the end of every session. + Assists the Senior Online Program Manager in sending regular messages through...maintains procedural documents. + Servers as backup for the Senior Online Program Manager. + Attends and participates in… more
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