- 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 ... integrity auditor to take appropriate action. Prepares necessary documentation for insurance appeals process, ensuring timely follow through. Processes claim… more
- Point32Health (FL)
- …as a customer service or member services representative in health care or insurance + Preferred: 2 years' Appeals and Grievance experience **Skill Requirements** ... **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Appeals and...NCQA (National Committee for Quality Assurance), DOI (Dept of Insurance ), CMS, DOL and any state or federal specific… more
- Guthrie (Sayre, PA)
- …within the unit. Takes the necessary action to complete all types of complex insurance billings and appeals . Reviews and analyzes the insurance processing ... Position Summary: Fulfills all requirements of Insurance Specialist I, as well as serving as...skills and proficiency in analyzing complex billing problems, prepares appeals , challenges payer policies and pursues appeal turnover when… more
- Robert Half Accountemps (Port Washington, NY)
- …role requires strong communication skills and the ability to handle complex insurance claims, appeals , and patient inquiries. Responsibilities: * Review denied ... medical claims and file appeals as needed. * Address patient inquiries regarding claim...needed. * Address patient inquiries regarding claim issues and insurance coverage with professionalism and clarity. * Billing and… more
- LA Care Health Plan (Los Angeles, CA)
- Registered Nurse (RN) Manager, Appeals and Grievances General Operations (Clinical) Job Category: Clinical Department: CSC Appeals & Grievances Location: Los ... the safety net required to achieve that purpose. Job Summary The Manager, Appeals & Grievances (A&G) & General Operations (Clinical) is responsible for the daily… more
- BronxCare Health System (Bronx, NY)
- Overview The Appeals Manager is responsible to assist in the analysis and preparation of response to denial notification letters that arrive in letter and electronic ... format. Collaborating with the Department Denial and Appeals Coordinators, Physician Advisors, and the clinical staff, the Appeal Manager is responsible to develop a… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Director Pre Appeals Management-HSO Appeals Management -Corporate 42nd Street-Full-Time-Days -Remote** The Director, Pre Appeals ... who provides strategic leadership and operational oversight for the hospital's pre- appeals management program. This role ensures the appropriate use of medical… more
- Evolent (Springfield, IL)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Specialty Appeals Team offers candidates the opportunity to make a meaningful impact as part of ... a highly trained dedicated team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and… more
- MTA (Brooklyn, NY)
- Assistant General Counsel III - Appeals , Torts Job ID: 12066 Business Unit: New York City Transit Location: Brooklyn, NY, United States Regular/Temporary: Regular ... Posted: Jul 10, 2025 Description Job Information Assistant General Counsel III - Appeals , Torts First Date of Posting: 7/10/2025 Last Date of Filing: Until Filled… more
- Point32Health (MA)
- …. **Job Summary** SUMMARY Under the general direction of the Member Appeals and Grievance Supervisor the Member Appeals and Grievance Analyst ... the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual works… more