- Beth Israel Lahey Health (Charlestown, MA)
- …all commercial and government clinical appeals and audit processes. The Clinical Analyst will perform high-level clinical appeal for services in the ... role. Reporting to the Manager, Patient Financial Services, the Clinical Analyst plays an important role in...to gather information that would support submitted charges. Prepare clinical appeals relevant to the audits in… more
- Stanford Health Care (Palo Alto, CA)
- …and regulatory requirements, as well as excellent analytical and communication skills. The Clinical Government Audit Analyst and Appeals Specialist II will ... is a Stanford Health Care job.** **A Brief Overview** Clinical Government Audit Analyst and Appeal Specialist...Revenue Cycle Denials Management Department by managing and resolving clinical appeals related to government audits and… more
- HCA Healthcare (Nashville, TN)
- …VA). Do you want to join an organization that invests in you as a Senior Appeals Analyst ? At Parallon, you come first. HCA Healthcare has committed up to $300 ... a difference. We are looking for a dedicated Senior Appeals Analyst like you to be a...researches and Resolves High Dollar Technical and Top Dollar Clinical Appeals through concise understanding of Payer… more
- Motion Recruitment Partners (Birmingham, AL)
- Appeals and Grievance Analyst Birmingham, Alabama **Onsite** Contract $18/hr - $28/hr Are you detail-oriented, highly organized, and passionate about making a ... difference in healthcare? We are seeking several Appeals and Grievances Consultants s for an onsite contract...2 years of related experience in claims, health, and clinical engagement and/or customer service + Strong verbal communication… more
- Elevance Health (Indianapolis, IN)
- …of claims, by translating medical policies, reimbursement policies, and clinical editing policies into effective and accurate reimbursement criteria.** PRIMARY ... policies, reimbursement policies, and editing rules, as well as conducting clinical research, data analysis, and identification of legislative mandates to support… more
- CareFirst (Baltimore, MD)
- …workflow and process mapping in Guiding Care for core care management and clinical appeals workflows. + Assesses how proposed configuration management changes ... may impact systems sustainment and supportability and makes recommendations on potential process changes. + Provides day to day operational support, including product configuration error handling and issue resolution by analyzing back-end logs + Participates… more
- City and County of San Francisco (San Francisco, CA)
- …years of verifiable professional human resources experience, similar to 1241 Human Resources Analyst , in one or more of the following areas of activity: recruitment ... training. Substitutions: Additional qualifying work experience as a professional human resources analyst may be substituted for up to two years of the required… more
- City and County of San Francisco (San Francisco, CA)
- …MIS resource for an organization with a complex system. The Senior IS Business Analyst is the advanced journey level in the Business Analyst series. Positions ... (eg Public Health, Epidemiology, Health Insurance) technology or within a clinical systems environment. Substitution: Additional experience as described above may be… more
- City and County of San Francisco (San Francisco, CA)
- …GIS Business Analyst Collaborates with Population Health, Street Health, and clinical teams to manage and analyze geospatial data. Works with IT developers to ... supports system upgrades, and collaborates across teams to meet clinical , revenue, and operational goals. Strong understanding of ...Rule 111A.35.1. The standard for the review of such appeals is 'abuse of discretion' or 'no rational basis'… more
- Immigration and Customs Enforcement (Washington, DC)
- Summary The Claims Management Program Analyst supports the Health Plan Management Unit by managing claims, provider recruitment, and compliance with healthcare ... AND RESPONSIBILITIES: Serves in the capacity as a Claims Management Program Analyst ; handles and assists program activities and policies related to claims… more