- CDPHP (Albany, NY)
- …share these values and invites you to be a part of that experience. The Appeals Coordinator is responsible for the timely and accurate triaging all appeals ... necessary information to process their requests within regulatory guidelines. The Appeals Coordinator is also responsible for daily/weekly/monthly department… more
- Kelsey-Seybold Clinic (Pearland, TX)
- …to meet both Corporate and CMS regulatory standards. **Job Title: Appeals & Grievances Coordinator ** **Location: Pearland Administrative Office** **Department:** ... This role actively manages all Medicare reconsiderations, grievances, and appeals , adhering to company policies and CMS regulatory requirements. As… more
- Geisinger (Danville, PA)
- Job Summary Provides support in administration of the Appeals and Grievance process. Serves as a liaison between Members and the Plan with appeals regarding ... benefit issues and concerns regarding quality of care or service. PresentsMember appeals to the Plan Medical Staff and Center for Medicare/Medicaid Services… more
- G-TECH Services, Inc. (Detroit, MI)
- Process appeals and grievances, analyze, research, and provide comprehensive responses in accordance with established regulatory and accreditation guidelines. ... Skills/Experience - Optional but preferred skills/experience. Include: * Grievance and Appeals experience. * Degree in Healthcare/computer skills * Experience in… more
- Corewell Health (Grand Rapids, MI)
- Job Summary The Appeals intake coordinator position is focused on the processing of incoming member and provider Medicare appeals and grievances. This team ... member will screen incoming complaints and appeals for level of urgency, benefit or medical necessity...teams as necessary to effectively triage incoming complaints and appeals . Essential Functions + Triaging of incoming appeals… more
- CVS Health (Annapolis, MD)
- …(facility) independent, external review request. The primary role of the Complaint and Appeals Sr. Coordinator is to manage to resolution 3rd Party Provider ... mail distribution, and managing incoming telephone calls. The Complaint and Appeals Sr. Coordinator for the National External Review Unit will: * Research and… more
- Baylor Scott & White Health (Temple, TX)
- **JOB SUMMARY** The Appeals and Grievance Coordinator is responsible for intake into the Appeals and Grievances Department, including verbal and written ... complaints, grievances and requests for appeals that involve complex matters submitted by Members and...written and fax referred cases from member and provider appeals and complaints for all lines of business, ensuring… more
- Crossroads Hospice & Palliative Care (Green, OH)
- …backgrounds + Problem-solving skills to research and resolve discrepancies, denials, appeals , collections Billing Coordinator Schedule & Benefits: + Schedule: ... we can create lasting impacts that transcend medical treatment. Billing Coordinator Responsibilities: + Obtain referrals and pre-authorizations as required for… more
- Apex Health Solutions (Houston, TX)
- …as part of the preauthorization process; flags cases for review by the Appeals & Outcomes Coordinator Reports potential risk management cases or situations ... as needed for reporting, as maybe delegated by the Quality & Outcomes Coordinator . Adheres to and apply all Health Solutions policies, procedures, and guidelines… more
- University of Utah Health (Salt Lake City, UT)
- …Supervise the day-to-day activities of staff who process member and provider Grievance and Appeals . + Monitor and set goals for staff workloads. + Ensure that staff ... are processing Grievances and Appeals efficiently and in compliance with applicable policies, regulations,...its regulations may be referred to the Title IX Coordinator , to the Department of Education, Office for Civil… more