- Covenant Health Inc. (Knoxville, TN)
- Overview Insurance Appeals Senior , Revenue Integrity and Utilization Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health ... (https://careers-covenanthealth.icims.com/jobs/67556/ insurance - appeals - senior /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336232841) Job Title INSURANCE APPEALS SENIOR ID 4357425… more
- Centene Corporation (Jefferson City, MO)
- …medical directors and supervise MD's responsible for utilization management and appeals functions to ensure members receive medically necessary, evidence-based care ... the enterprise. + Provide medical leadership for all utilization management ( appeals ), pharmacy, case management, disease management, cost containment, and medical… more
- Ochsner Health (New Orleans, LA)
- …The Appeals Specialist is responsible for managing and resolving insurance claim denials and underpayments to ensure accurate reimbursement. This role involves ... Preferred - + Experience in healthcare or revenue cycle - specifically insurance claim denials. + Strong analytical and organizational skills. + Excellent… more
- Corewell Health (Grand Rapids, MI)
- …to internal departments. Serves as a mentor/trainer to other team members.The Senior Appeals Analyst makes decisions on moderately complex issues regarding ... This position will support our non-contracted provider post claim appeals submitted to the health plan. Job Summary Responsible for the analysis, research and… more
- CenterWell (Denver, CO)
- …data analytics, denial and appeal process. The Director, Home Health Grievances & Appeals assists members, via phone or face to face, further/support quality related ... development/implementation required + Expert knowledge of all Medicare regulations and appeals processes + Excellent analytical skills with ability to interpret and… more
- Centene Corporation (Jefferson City, MO)
- …high-quality, cost-effective care to our members. This role further assists the Senior Medical Director or Chief Medical Officer in execution of strategic clinical ... utilization and health care quality + Oversee and actively participate in the appeals process, ensuring that appeals are handled efficiently, thoroughly, and in… more
- Houston Methodist (Sugar Land, TX)
- At Houston Methodist, the Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical ... denial management and appeals process, as applicable, in collaboration with clinical team partners. This position uses sound clinical judgement in the Utilization… more
- Ophthalmic Consultants of Boston (Plymouth, MA)
- …operations. This role handles a high volume of claims processing, insurance denials, appeals , contract management, prior authorization submissions, and ... with a demonstrated ability to apply this knowledge to claim processing and appeals . + Extensive experience managing insurance denials, appeals , and… more
- GuideOne Insurance (Nashville, TN)
- As Senior Counsel, you will play a pivotal role in managing complex litigation and a broad range of legal matters within your state of licensure. In this ... depositions. + Prepares and drafts pre-trial motions. + Files or defends motion appeals . + Tries lawsuits. + Prepares and drafts post-trial motions. + Manages legal… more
- HCA Healthcare (Nashville, TN)
- **Description** **Introduction** Do you have the career opportunities as a Quality Control Senior Manager you want with your current employer? We have an exciting ... plans (accident, critical illness, hospital indemnity), auto and home insurance , identity theft protection, legal counseling, long-term care coverage, moving… more