• Claim Appeals And Audit Specialist

    CenterLight Health System (NY)
    JOB PURPOSE: The Claim Appeals and Audit Specialist will play a pivotal role in enhancing the efficiency and effectiveness of the claims department by timely and ... accurate processing of claims appeals and performing claims audit, ensuring payment integrity and...etc., and type/write documentation, etc. with accuracy. + Audio Hearing and Motor Skills (Language) Requirements - Must be… more
    CenterLight Health System (04/26/25)
    - Related Jobs

  • Coding Appeals Specialist

    St. Luke's University Health Network (Allentown, PA)
    …regardless of a patient's ability to pay for health care. The Coding Appeals Specialist retrospectively reviews patient medical records, claims data and coding ... are assigned to support the services/treatment rendered. The Coding Appeals Specialist also prepares appeal arguments and/or...record and abstracting of patient information. Corrected vision and hearing to within normal range. Hearing as… more
    St. Luke's University Health Network (05/19/25)
    - Related Jobs

  • Appeals & Grievances Program Advisor

    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...NCQA requirements. + Coordinate BOH hearings with external State Hearing Board + Help with preparation of NCQA audit… more
    Commonwealth Care Alliance (05/21/25)
    - Related Jobs

  • Clinical Appeals Nurse (RN)

    Molina Healthcare (Tacoma, WA)
    **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and correct clinical decisions for appeals outcomes within compliance ... standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical/medical reviews of previously denied cases in which a formal appeals… more
    Molina Healthcare (05/16/25)
    - Related Jobs

  • ECMC Enforcement Advisor (Compliance…

    State of Colorado (Denver, CO)
    ECMC Enforcement Advisor (Compliance Specialist IV) - Remote/Hybrid Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4887965) Apply  ECMC ... Enforcement Advisor (Compliance Specialist IV) - Remote/Hybrid Salary $68,100.00 - $91,200.00 Annually Location Denver Metro, CO Job Type Full Time Job Number PHA… more
    State of Colorado (05/14/25)
    - Related Jobs

  • Specialist -Denial II RN

    Baptist Memorial (Memphis, TN)
    Overview Specialist -Denial Mitigation II RN Job Code: 21432 FLSA Status Job Family: FINANCE Job Summary The Denial Mitigation-Appeal Specialist II RN serves in a ... in order to defend our revenue. The Denial Mitigation-Appeal Specialist II RN reviews the denial received from the...may be required to defend appeal in a payer hearing or clinical meeting when indicated. The Denial Mitigation-Appeal… more
    Baptist Memorial (04/12/25)
    - Related Jobs

  • Specialist -Denial II RN

    Baptist Memorial (Memphis, TN)
    Overview Specialist -Denial Mitigation II RN Job Code: 21432 FLSA Status Job Family: FINANCE Job Summary The Denial Mitigation-Appeal Specialist II RN serves in a ... in order to defend our revenue. The Denial Mitigation-Appeal Specialist II RN reviews the denial received from the...may be required to defend appeal in a payer hearing or clinical meeting when indicated. The Denial Mitigation-Appeal… more
    Baptist Memorial (04/11/25)
    - Related Jobs

  • Highway Maintenance Specialist - Rabbit…

    State of Colorado (Routt County, CO)
    Highway Maintenance Specialist - Rabbit Ears Pass (CDL Required & $1000/mo Housing) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4957832) ... Apply  Highway Maintenance Specialist - Rabbit Ears Pass (CDL Required & $1000/mo...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
    State of Colorado (05/31/25)
    - Related Jobs

  • Highway Maintenance Specialist - Winter…

    State of Colorado (Grand County, CO)
    Highway Maintenance Specialist - Winter Park (CDL Training Provided & $1000/mo Housing) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4957808) ... Apply  Highway Maintenance Specialist - Winter Park (CDL Training Provided & $1000/mo...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
    State of Colorado (05/31/25)
    - Related Jobs

  • Highway Maintenance Specialist - Mancos

    State of Colorado (Montezuma County, CO)
    Highway Maintenance Specialist - Mancos Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4954311) Apply  Highway Maintenance Specialist - ... your passions into a career as a Highway Maintenance Specialist . CDOT has a vacancy for a Highway Maintenance...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
    State of Colorado (05/29/25)
    - Related Jobs