• Claims Appeals Representative…

    Covenant Health (Lubbock, TX)
    **Description** ** Claims Appeals Representative ** **Works collaboratively with Case Management (CM) Leadership, Case Managers (CM), Complex Discharge ... 3 or more years of experience in managed care claims / reimbursement setting or experience working in another other...1 or more years of experience in managed care claims / reimbursement + 1 or more years of… more
    Covenant Health (07/17/25)
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  • RN Clinical Review Appeals Specialist

    St. Luke's University Health Network (Allentown, PA)
    …of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding ... by the government or commercial payors, or their auditor representative . + Facilitate clinical chart reviews to assist with...preparing reports regarding denials to include volumes, number of appeals , case resolution, and impact on revenue… more
    St. Luke's University Health Network (07/08/25)
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  • TVC - Claims Benefit Advisor (Veterans…

    Texas Veterans Commission (Midland, TX)
    …rulings, and state law in the adjudication process. . Prepares and files claims and appeals with supporting evidence for successful adjudication. . Advises ... Financial Operations* **Organization:** **TEXAS VETERANS COMMISSION* **Title:** *TVC - Claims Benefit Advisor (Veterans Services Representative I)* **Location:**… more
    Texas Veterans Commission (06/24/25)
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  • Senior Cross Functional Collections…

    UCLA Health (Los Angeles, CA)
    …medical terminology, and confidentiality compliance + Proven ability to resolve complex claims , process adjustments, and manage appeals effectively + Proficiency ... Description UCLA Health is seeking a Senior Cross-Functional Collections Representative to support Patient Business Services by managing a diverse portfolio of… more
    UCLA Health (07/18/25)
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  • Case Manager

    Cardinal Health (Santa Fe, NM)
    …needs of the patient and/or program + Resolve patient's questions and any representative for the patient's concerns regarding status of their request for assistance ... + Follow through on all benefit investigation rejections, including Prior Authorizations, Appeals , etc. All avenues to obtain coverage for the product must be… more
    Cardinal Health (07/16/25)
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  • Physician Support Representative

    University of Rochester (Rochester, NY)
    …composes edits and obtains signatures for non-routine letters of correspondence related to appeals on denied claims . + This includes compiling all necessary ... overbooking and rearranging of surgeons Operating Room schedules based on case complexity and medical urgency. + Authorizes rescheduling when cancellations occur… more
    University of Rochester (07/19/25)
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  • Clinical Reviewer

    Independent Health (Buffalo, NY)
    …of internal and external service groups. + Coordinate with external agencies to prepare case files when needed for external appeals . + Thorough and accurate ... completion of log worksheet to maintain consistency in logging complaints/ appeals . Maintain and monitor outstanding case logs to plan and prioritize workload.… more
    Independent Health (07/09/25)
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  • Compliance Investigator I: Dora/Divison of Civil…

    State of Colorado (Denver, CO)
    …parties the option of alternative dispute resolution and either refer the case appropriately or conduct informal settlement discussions. Duties include, but are not ... information, data, and affidavits from parties, compiling and organizing case files, preserving evidence, examining documentation, analyzing evidence, conducting… more
    State of Colorado (07/23/25)
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  • National Service Officer I

    Wounded Warrior Project (Phoenix, AZ)
    …military service. The NSO guides and manages the preparation and processing of all claims and subsequent appeals through the Department of Defense (DoD) and ... the DoD and DVA. + Prepare briefs for pending appeals located at the local VA Regional Office level....laws, regulations, and benefits. + Maintain and update WWP case management electronic tracking systems. + Develop community support… more
    Wounded Warrior Project (06/21/25)
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  • Promise Jobs Workforce Advisor

    Iowa Department of Administrative Services (Spencer, IA)
    …public contact work obtaining, analyzing and evaluating data such as job/ claims interviewing, testing, referral and/or placement, sales representative , credit ... public contact work obtaining, analyzing and evaluating data such as job/ claims interviewing, testing, referral and/or placement, sales representative , credit… more
    Iowa Department of Administrative Services (07/19/25)
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