- R1 RCM (Detroit, MI)
- …sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our **Clinical Appeals Supervisor ** , you will help support clinicians who ... this remote position. **Here's what you will experience working as a Clinical Appeals Supervisor :** + Track and monitor the workflow of the clinical team daily… more
- R1 RCM (Salt Lake City, UT)
- …analytics, AI, intelligent automation, and workflow orchestration. As our **Clinical Coding Appeals Supervisor ** , you will support clinical coders and coding ... guidelines. **Here's what you will experience working as a Clinical Coding Appeals Supervisor :** + Track daily inventory of cases and coordinate assignments to… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- Centralized Appeals Unit - Supervisor Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4881433) Centralized Appeals Unit - ... + Description + Benefits Supplemental Information Please click HERE (https://ulsuno.wd1.myworkdayjobs.com/en-US/UniversityOfNewOrleans/job/Baton-Rouge-La/Centralized- Appeals -Unit Supervisor \_R-001713?q=R-001713) to apply + Manage and… more
- AmeriHealth Caritas (Philadelphia, PA)
- …services. ;Discover more about us at www.amerihealthcaritas.com. **Position Overview:** The Appeals Specialist reports to the Supervisor of Appeals ... and Part D drugs. ; **Key Responsibilities:** + Analyze and respond to appeals from members, member representatives, and providers regarding denials for services and… more
- Point32Health (MA)
- …colleagues and communities. **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Member Appeals and Grievance ... the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual works… more
- Fallon Health (Worcester, MA)
- …information, visit fallonhealth.org. **Brief Summary of Purpose:** Fallon Health's (FH) Appeals and Grievance process is an essential function to FH's compliance ... other applicable regulatory requirements and member and provider expectations. The FH Appeals and Grievances Triage Administrator serves to administer the FH … more
- Catholic Health Services (Melville, NY)
- …Island's Top Workplace! Job Details Position Summary: The Utilization and Appeals Coordinator will perform activities to help facilitate utilization management and ... appeals functions to include coordination of specific process and...all insurance and regulatory audits and provides information to supervisor related to inaccurate and/or missing documentation as applicable.… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, ... required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve member… more
- Commonwealth Care Alliance (Boston, MA)
- 011540 CCA- Appeals & Grievances **Position Summary:** Appeals and Grievances Program Advisor monitors and supports the operations and compliance of the ... Appeals and Grievances department through many NCQA and other...Federal and State Regulations. Complete individual summary scorecards for Supervisor feedback. + Track monthly scores on spreadsheet and… more
- State of Massachusetts (Boston, MA)
- …and Bonds ("the board"), which is responsible for conducting administrative hearings for appeals of actions, rulings or decisions of the Registrar of Motor Vehicles ... a record of all proceedings before the board and shall collect data on appeals , board outcomes and key performance metrics as determined by the Commissioner of… more
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