$93.4k - $116.8k
...Overview
Resolves grievances, appeals and external reviews for one of the following VNS Health Plans product lines – Managed Long Term Care (MLTC), Medicare Advantage (MA), or Select Health. Ensures regulatory compliance, timeliness requirements and accuracy standards...
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Full time
Work experience placement
Relocation bonus
Flexible hours
...States*** JOB DESCRIPTION
Job Summary
Responsible for leading, organizing and directing the activities of the Grievance and Appeals Unit that is responsible for reviewing and resolving member and provider complaints and communicating resolution to members or authorized...
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...committed to improve the quality of care we deliver every day. TMC Bonham is managed by Texoma Medical Center, subsidiary of UHS.
The Appeals Specialist is responsible for appealing all insurance denials and prepare relevant reports regarding trends in denials....
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...Job Title: Mass Properties Engineering
Job Type: Full Time; Contract
Location: Savannah, GA
Schedule: 1st Shift
Bachelor's Degree in engineering or related curriculum required or equivalent combination of education and experience sufficient to successfully...
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Appeals Provider
Appeals Provider
JOB_52232741161928
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Job type Contract
Location Tampa Bay/...
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...APPEALS SPECIALIST
WHY YOU SHOULD BE THE APPEALS SPECIALIST
Our client is a law firm located in Cleveland, Ohio
Hybrid 1 day per week
Great health benefits, competitive PTO and retirement
Paid Maternity leave and tuition assistance
RESPONSIBILITIES...
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1 day per week
Join a team of dynamic, results oriented professionals!
Named among "The World's Most Admired Companies" by Fortune Magazine
Named among "America's 100 Most Trustworthy Companies" by Forbes magazine
Named among "Great Places to Work" by Becker's Hospital...
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...disease. Yet, proteins remain understudied because of technological hurdles.
How? To resolve these limitations, PTI will develop mass tags enabling a new framework for multiplexed protein analysis by mass spectrometry towards achieving 100-fold increase in...
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...Company Generac Power Systems
Name Appeals & Grievances Specialist I
Req # 64663
Employment Type Full Time
Shift 1st
It's a challenge, and an invitation. Most importantly, it's an opportunity to join an industry leader.
There...
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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
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...time off
~ Eight Paid Holidays per year
~ Quarterly incentive plans
*The Akron, OH billing center has multiple openings for Appeals Representatives. These are remote, work-from-home positions*
JOB DESCRIPTION OVERVIEW:
~ The Denials & Appeals...
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...Grievance and Appeals Coordinator
75 Vanderbilt Ave, Staten Island, NY 10304, USA
Req #660
Friday, May 3, 2024
Centers Plan for Healthy Living's goal is to create the ultimate healthcare experience that provides our members, their families, healthcare decision...
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Hourly pay
...appropriate.
Provide correction suggestions to other departments so the invoice can be resubmitted.
Provide coding direction to appeal invoices and/or submit appeals via payer website or fax, as directed.
Complete reconsideration letters as needed.
Complete...
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Job Type
Full-time
Description
Job purpose
~ The Appeals Specialist is responsible for managing insurance denials by reviewing claims and clinical documentation, posting payments, handling correspondence letters and writing appeals to correct payment amount...
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Work experience placement
Local area
...state of California. This is a remote role.
**Position Purpose:** Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members.
+ Gather, analyze and report verbal and written member...
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...workplace flexibility.
**Must be located in California - occasional in-office meetings.**
**Position Purpose:** The Supervisor of Appeals & Grievances is accountable for the recruitment, hiring, promotion, counseling, and daily supervision of Grievance and Appeals...
Holiday work
Remote job
Flexible hours
...ESSENTIAL DUTIES AND RESPONSIBILITIES
•Track all appeals activity in collaboration with the Director of Denials and Appeals.
•Maintain all files as needed;
•Answer all hospital queries and provide guidance to appeals process.
•Assist appeals staff to track and...
...JOB TITLE : Catholic Mass Musician
LOCATION : Keesler AFB. Catholic Chapel, Biloxi , MS 39534
DUTIES :
~ Provides instrumental and accompaniment music for congregation singing and choral selections.
Demonstrates proficiency on a secondary instrument of...
Responsibilities
One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed ...
Local area
...improvement decisions.
Pay is $1,284 per credit hour.
GENERAL JOB SUMMARY: Kirkwood Community College is seeking a part-time Mass Media faculty member to teach a variety of Mass Media courses. We are looking for instructors to teach at the Main Campus in Cedar Rapids...
Part time
Weekday work
Job Description
Job Description Our AOG program offers excellent pay, industry -leading benefits AND a one week on/one week off schedule. You are paid for a minimum of 40 hours EVERY week. In addition to BED, , we also have needs at the following locations:
BZN...
Local area
Immediate start
Shift work
All shifts
...provider type for all correspondence
Provide reports and on-going updates to Claims management.
Assist in the processing of appeals (reconsiderations), special projects and reconciliations from all sources.
Oversees staff activities to maintain high level of productivity...
Hourly pay
Holiday work
Full time
Contract work
Casual work
Relocation bonus
Flexible hours
...Appeals Specialist I
Remote within WA, ID, OR, and UT
Primary Job Purpose:
Responsible for all activities associated with requests for Provider Billing Disputes and Appeals. Includes analysis, preparation, evaluation of prior determinations, coordination...
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...people safe. We’re looking for passionate people to join our team as we continue leading the industry over our next 100 years.
The Mass Media Specialist will support the Manager of Mass Media on day-to-day mass media strategy development, budget planning, campaign...
Worldwide
...serve through compassionate, innovative, patient-centered care.
JOB SUMMARY
This position is responsible for managing the appeal of unpaid claims in the Central Business Office. This position will also work closely with insurance carriers in resolving unpaid claims...
Remote job
...Job Description
Job Description The Appeals Representative is responsible for addressing provider inquiries and appeals via email, fax, telephone, or written correspondence ensuring adherence to client policy, industry standards along with CMS and state guidelines...
Hourly pay
Minimum wage
Full time
Contract work
Local area
Remote job
Flexible hours
...DESCRIPTION OVERVIEW:
This position is responsible for reviewing various carrier denials at their assigned Billing Group and submitting appeals accordingly.Maintains accuracy and production to ensure invoices are being processed efficiently.
ESSENTIAL DUTIES AND...
Remote job
Holiday work
Flexible hours
...spent on the particular responsibility - High to Low
1.
Manages workflow for Humana PPI Audits, RAC Audits, or Outpatient Appeals and communicates daily with Sr. Director/Manager on trends identified
2.
Responds to queries within 72hrs, appropriately documents...
...reside within the state of Arizona.**
**Position Purpose:** Analyze and resolve verbal and written claims and authorization grievance/appeals from providers and members. Resolve all State inquires related to complaints, grievances and appeals.
+ Review and process member...
Hourly pay
Holiday work
Remote job
Flexible hours
...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...
Holiday work
Full time
Work experience placement
Immediate start
Remote job
Relocation
Visa sponsorship
Shift work