- R1 RCM (Salt Lake City, UT)
- …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
- AmeriHealth Caritas (Newark, DE)
- …Discover more about us at www.amerihealthcaritas.com. **Responsibilities:** Reporting to the Supervisor , Appeals and Grievances, this position is responsible for ... the administrative tasks for coordination of member and/or provider appeals , the analysis of claims and appeals ,...provider appeals , the analysis of claims and appeals , and the review of medical management authorizations.; +… more
- Point32Health (MA)
- …(https://www.point32health.org/) . **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Appeals and Grievance ... the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual works… more
- State of Massachusetts (Boston, MA)
- …Records ( Supervisor ), the Division processes and issues determinations on appeals from petitioners denied access to government records; responds to inquires ... case-law, statutes, regulations, Attorney General Opinions, Executive Orders and prior Supervisor Determinations; . Review appeals from public records requesters… 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
- State of Michigan (Lansing, MI)
- …other duties assigned by the position's supervisor . Position Description (https://mcsc.state.mi.us/AgencyPDFs/ Appeals %20Position%20Description.pdf) Job ... Departmental Specialist 13 - Appeals Review Officer - Legal Affairs Print (https://www.governmentjobs.com/careers/michigan/jobs/newprint/5049167) Apply … more
- HonorHealth (AZ)
- …medical records documentation and billing statements on patient accounts; submits appeals to payers on patient account denials when appropriate; reviews medical ... appeal is clearly presented. Prioritizes and organizes own work to meet appeals and grievance deadlines. Responsible for the denials process, including subsequent… more
- TEKsystems (Richmond, VA)
- …Process specialized cases with a high degree of difficulty. - Work and research appeals at supervisor discretion. Serve as SME on eligibility policy and ... processes for team and understand impact on other teams. - Work closely with management and work groups to create and maintain work plan documents. - Track the status and due dates of projects. - Collaborate with project managers on various initiatives and… more
- Veterans Affairs, Veterans Health Administration (San Diego, CA)
- …informal complaints of employees and referring others, such as formal grievances and appeals to the supervisor or an appropriate management official. Prepares ... direction relating to the telehealth program. Works with the supervisor to develop assignments for team members in order...status and progress of work to ensure that the supervisor 's instructions on work priorities, methods, deadlines, and quality… more
- City and County of San Francisco (San Francisco, CA)
- …. Under general direction, the 9230 Airport Custodial Services Supervisor is responsible for all custodial services, furniture and equipment ... to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or...Rule 111A.35.1. The standard for the review of such appeals is 'abuse of discretion' or 'no rational basis'… more
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