Search Results: 166,444 vacancies
...Responsible for the management and communication of denials/appeals received from third party payers, managed care companies, and/or... ...for clinical denials and appeal inquiries. The Clinical Appeals Nurse will review each case identified/referred for appeal based on Milliman...
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Permanent employment
For contractors
Relief
$100k - $110k
The Denials and Appeals Manager will be responsible for overseeing the denials and appeals process to ensure timely and accurate resolution... ...denied claims. The ideal candidate will have a background in nursing, experience in insurance, and expertise in utilization review....
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Full time
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...platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration.
As our **Clinical Coding Appeals Nurse** , you will help review and interpret medical records to draft appeals of denied and underpaid claims. Every day you will...
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...JOB DESCRIPTION
For this position we are seeking a (RN) Registered Nurse who must be licensed in the state you reside.We are looking for a Clinical Nurse Appeals RN to support our SC Health plan (Medicaid and Marketplace). Strong experience with appeals reviews and...
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Remote job
Full time
Work experience placement
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Monday to Friday
Summary
SUMMARY: Coordinates and executes the appeal process for all AHS facilities clinical appeals and third party audits.
DUTIES... ....
MINIMUM QUALIFICATIONS:
Preferred Education: Master's in Nursing.
Preferred Licenses/Certifications: Certification in Case Management...
Suggested
Full time
...Cigna Medicare Part C Appeals Reviewer: Appeals Processing Analyst
We will depend on you to communicate some of our most critical information... ...assigned.
Qualifications
~ Education: Licensed Practical Nurse (LPN) or Registered Nurse (RN)
~3-5 years' experience in...
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Holiday work
Full time
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Local area
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Monday to Friday
...Job Description
Division/Unit: Appeals Division
Position Title: Appeals Paralegal
Civil Service Title: Community Associate
Salary Range: $49,000 - $51,984
Job Description:
The New York County District Attorney's Office anticipates openings beginning in...
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Summer work
Shift work
Monday to Friday
...hire will be located within 50 miles of a company office (Pulse. Point) and may get asked to attend a town hall office meeting once a quarter. The Pharmacist Clinical Appeals is responsible f Clinical, Pharmacist, Appeals, Medical Director, Clinic, Healthcare, Benefits...
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Remote job
...Office Locations:
Tustin, CA - Las Vegas, NV - Oklahoma City, OK - Uniondale, NY - Tampa, FL
The Supervisor Grievances and Appeals , under the direction of the Manager Grievances and Appeals, is responsible for supervision of the Grievances and Appeals unit, daily...
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Holiday work
Full time
Work experience placement
Immediate start
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Relocation
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...Appeals and Compliance Specialist
Starting Salary: $84,495 - $101,395
This position reports to the Executive Director and is responsible for managing complaints, informal resolution meetings, mediations, and appeals, ensuring compliance with state and federal laws...
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Local area
Flexible hours
....
With more than 13,000 team members physicians, surgeons, nurses, pharmacists and other highly-skilled health care professionals,... ...JOB SUMMARY
This position is responsible for managing the appeal of unpaid claims in the Central Business Office. This position will...
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Remote job
...Rico and the United Kingdom.
The Atlantic Region CBO is seeking a dynamic and talented Clinical Documentation Improvement (CDI) Nurse.
The Clinical Documentation Improvement (CDI) Nurse provides clinically based concurrent and retrospective review of inpatient...
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Local area
...Clinical Coding Appeals Author at R1 RCM in Boise, Idaho, United States Job Description As a Clinical Coding Appeals Author , you will help review and interpret medical records to draft appeals of denied and underpaid claims. Every day you will, review medical records...
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...Anticipated End Date:
2024-05-23
Position Title:
Grievance/Appeals Representative II
Job Description:
Grievance/Appeals Representative II
Location: Hybrid 500 Unicorn Park Drive Woburn, MA
The Grievance/Appeals Representative II is responsible for...
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Temporary work
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Day shift
...frequently completed without established procedures Works independently May act as a resource for others May coordinate others' activities Requires current pharmacy technician state license or nat Technician, Pharmacy Technician, Appeals, Pharmacy, Senior, Health, Healthcare...
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Work experience placement
...Job Category
Member Services
Description
Salary:$22.56/hour - $31.00/hour
Under the supervision of the MS Grievance & Appeals Manager, this position will provide for the administrative initiation and potential resolution of member grievances and appeals (G&...
Full time
...Job Description
Claims Appeals Representative *Remote* Candidates in AK, WA, MT, OR, CA or TX are encouraged to apply.
The Appeal and Grievance Specialist position is responsible for day-to-day review, coordination and management of technical denials requiring background...
Remote job
Local area
Shift work
...Heard and Smith, LLP
Case Status and Appeals Representative
Heard and Smith, LLP was founded on the principles of compassion, humility and the relentless desire to pursue financial assistance for our clients. Our law firm has been helping the disabled for over...
Hourly pay
Holiday work
Immediate start
Remote job
Work from home
Home office
...Medical Director - Pharmacy Appeals at Humana in Boise, Idaho, United States Job Description Become a part of our caring community and help us put health first The Medical Director relies on broad clinical expertise to review Medicare drug appeals (Part D & B). The Medical...
Local area
...departmental requests. Supports the MedStar Family Choice Department of Appeals/Grievances/ER Reviews for Maryland Appeals and Grievances, and... ..., and research. Our team of 32,000 includes physicians, nurses, residents, fellows, and many other clinical and non-clinical...
Work experience placement
Local area
Immediate start
