- 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 ... to best respond to all hospital denials notification and documentation efforts. The Appeals Manager will provide timely tracking and trending of all denials 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… more
- BronxCare Health System (Bronx, NY)
- …the analysis and preparation of responses to payor denials and develop strong appeals for the purpose of securing reimbursement for acute care services provided to ... identification of patterns and trends identified during the course of appeals preparation. Conduct departmental performance improvement audits, analyze findings and… more
- Public Storage (Plano, TX)
- …and preferred stocks trade on the New York Stock Exchange. **Job Description** The Senior Manager , Property Tax Appeals and Analysis, is a key member of the ... Public Storage tax team, responsible for strategically managing the property tax appeals process across a national portfolio. This position reports directly to the… more
- Molina Healthcare (Houston, TX)
- …Manages team responsible for the submission/resolution of member and provider appeals and grievances; ensures resolutions are compliant with applicable standards and ... call tracking system of correspondence and outcomes for provider and member appeals /grievances; oversees/monitors appeals to ensure all internal and regulatory… more
- Providence (Torrance, CA)
- **Description** ** Appeals RN - Care Manager Remote. This position is Per Diem and will work 8-hour, Day shifts.** The Care Management Recovery Advocate (CMRA) is ... responsible for providing overall management and communication of clinically-based appeals between Providence Health and Services, California Region (PH&S) outside… more
- CareFirst (Baltimore, MD)
- …educational and training presentations for internal and external stakeholders. Supports the Manager of Clinical Appeals and Analysis in the development and ... **Resp & Qualifications** **PURPOSE:** The Clinical Appeals Supervisor directs and coordinates the accurate implementation...Licensure Upon Hire Required + CCM - Certified Case Manager Upon Hire Preferred + LNCC - Legal Nurse… more
- FirstEnergy (Akron, OH)
- …automation or AI where appropriate), strengthen controls and procedures, and handle audits and appeals . The Manager will report to the Director, Tax Planning and ... with FirstEnergy Service Company, a subsidiary of FirstEnergy Corp. The Manager , General Taxes, is responsible for compliance, accounting, forecasting, and planning… more
- Corewell Health (Grand Rapids, MI)
- …all components of insurance prior authorizations, initial reviews, continuous stay reviews and appeals . Nurse Care Manager - Plans and prioritizes care for ... waiting list, insurance prior authorizations, continuous stay reviews and appeals . Additional support to the UM functions of the...Cross Ambulatory Care Management Upon Hire required + Case Manager , Certified (CCM) - CCMC Commission for Case … more
- Garnet Health (Middletown, NY)
- …for the day to day operation of the CDI department and DRG Denials appeals process. The Manager will develop, implement and evaluate processes, policies and ... Administrator, Coding & Clinical Documentation Improvement and Patient Access, the Manager of Clinical Documentation Integrity (CDI) and DRG Denials is responsible… more
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