- UNC Health (Chapel Hill, NC)
- …communities we serve.RN Utilization Manager position specifically for a Utilization Manager/Clinical Appeals Nurse. This person is based at the Hedrick building and ... care transitions & appropriate utilization of services. Coordinates with the support center to assure third party payor pre-certification and/or re-certifications… more
- Army National Guard (Milan, IL)
- …matters and judicial work. The Paralegal Specialist provides legal and administrative support in areas like family law, international law, contract law, defense ... research court decisions and Army regulations, process legal claims and appeals , and prepare records of hearings, investigations, courts-martial, and courts of… more
- CHRISTUS Health (Alamogordo, NM)
- …Medicare Conditions of Participation, DNV standards, HIPAA, and reporting requirements. Submits appeals in a timely manner, upon request by the Director. Initiates ... care plans, including discharge planning, across the continuum of care in support of the GCRMC Mission. Communicates with providers regarding patient status and… more
- Randstad US (Woodland Hills, CA)
- … appeals and grievances + May coordinate the Grievance and Appeals Committee Support the pay-for-performance programs, including data entry, tracking, ... grievance and appeals coordinator. + woodland hills , california +...temp to perm + high school + category healthcare support occupations + referenceAB_4530740 job details A trusted client… more
- Centene Corporation (Salem, OR)
- …individual appeals and grievances + May coordinate the Grievance and Appeals Committee + Support the pay-for-performance programs, including data entry, ... **Position Purpose:** Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members.… more
- Elevance Health (Rancho Cordova, CA)
- **Manager II Grievance/ Appeals - Claims Support ** **Location: *CA Residential Requirement** This position will work a hybrid model (remote and office). Ideal ... within 50 miles of one of our PulsePoint locations. The **Manager II Grievance/ Appeals ** is responsible for management oversight of grievances and appeals … more
- CVS Health (Hartford, CT)
- …part C appeals (both provider and member/nonparticipating providers) and Part D appeals .* Provide direct support to appeal nurses and dedicated Medicare part ... after hours and weekend coverage on a rotational basis to support 24/7 appeals work* IRE monitoring and tracking and Utilization Management Strategy … more
- Penn Medicine (Bala Cynwyd, PA)
- …officer on contract negotiations with vendor as needed. + Offers assistance and support on appeals involving Administrative Law Judge + Manage and expedite ... 8:30AM -5:00PM The Director for Hospital Billing Compliance and Government Audits/ Appeals directs the planning, coordinating, scheduling and performance of annual… more
- Brighton Health Plan Solutions, LLC (Westbury, NY)
- …notice. Primary Responsibilities + Effectively manage Appeal Supervisors, providing full-time support to appeals , internal departments, vendors, and customers. + ... About The Role The Appeals Manager is responsible managing Appeal Supervisors and...Customer Service in resolving customer inquiries and concerns. + Support the Client Services department by researching and resolving… more
- Internal Revenue Service (Fresno, CA)
- …Vacancies will be filled in the following specialty areas: Office of Appeals Case and Operations Support Account and Processing Support ... CAREERS? Visit us on the web at www.jobs.irs.gov Responsibilities WHAT IS THE APPEALS DIVISION? A description of the business units can be found at:… more
