- BroadPath Healthcare Solutions (Tucson, AZ)
- **Overview** BroadPath is seeking a highly motivated and results-driven **UM RN Appeals Coordinator .** This role collaborates with clinical review staff, medical ... to ensure consistent clinical evaluation and processing of medical necessity appeals . Accurate documentation and detailed recordkeeping of notifications to members… more
- Community Health Systems (Franklin, TN)
- …reduce future denials, and ensure compliance with payer guidelines. As a Denial Appeals Coordinator at Community Health Systems (CHS) - PCCM, you'll play ... **Job Summary** The Denial Coordinator is responsible for reviewing, tracking, and resolving...reviewing, tracking, and resolving denied claims, ensuring that appropriate appeals are submitted, and working closely with payers, internal… more
- Conduent (Baton Rouge, LA)
- …**Are you eager to learn new skills and help adults in need?** As an Appeals Coordinator you will represent the customer, the Louisiana Department of Health ... role, you will:** + Review decision/denial letters on new appeals requests received, research data and materials to accumulate...to:** + Prepare summaries of evidence + Prepare for appeals + Document required reporting for position + Utilize… more
- Insight Global (Irvine, CA)
- Job Description An employer is looking for a remote Appeals & Grievances Coordinator that will be responsible for managing and resolving appeals and ... and external stakeholders. Key Responsibilities - Review, research, and process appeals and grievances in compliance with company policies and regulatory… more
- Dignity Health (Rancho Cordova, CA)
- …This position is hybrid in-office and work from home.** **Position Summary:** The Appeals and Grievances Coordinator is responsible for supporting the appeals ... department team members by managing and coordinating the appeals and grievance process. This role involves: - facilitating...and grievances. Acting a subject matter expert (SME), the Coordinator will work closely with internal teams and external… more
- Centene Corporation (Salem, OR)
- …RN or LPN** **Oregon state license **Utilization review, case management, and appeals experience in a managed care setting is strongly preferred** **Position ... Purpose:** Act as the liaison for all statewide appeals , fair hearings, review organizations, and other external type appeals . Responsible for ensuring that all… more
- Centene Corporation (Indianapolis, IN)
- …**Position Purpose:** Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members. ... verbal and written member and provider complaints, grievances and appeals + Prepare response letters for member and provider...response letters for member and provider complaints, grievances and appeals + Maintain files on individual appeals … more
- AmeriHealth Caritas (Philadelphia, PA)
- …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
- University of Southern California (Los Angeles, CA)
- …Ensures students complete assigned outcomes. Provides information as needed to the appeals coordinator . + Communicates and provides information about the ... Community Expectations Coordinator Office of Community Expectations (OCE) Application Process:...and its resources. About the Opportunity The Community Expectations Coordinator is responsible for Investigating, processing and resolving reported… more
- City of New York (New York, NY)
- …its work. Job Duties and Responsibilities: - Serve as the Reasonable Accommodations Appeals Unit coordinator and processing incoming requests. - Maintain an ... agencywide list of Executive Assistants for agency leadership that is updated and shared on a monthly basis. - Serve as a co-preparer for travel alongside the Operations Manager on travel for the Commissioner and other COH office staff. - Maintain the… more
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