- The Cigna Group (Nashville, TN)
- Cigna Medicare Part C Appeals Reviewer: Appeals Processing Analyst We will depend on you to communicate some of our most critical information to the ... and related issues, implications and decisions. The Case Management Analyst reports to the Supervisor/Manager of Appeals ...with all matrix partners to ensure accurate and timely processing of Medicare Appeals . + Read Medicare… more
- The Cigna Group (Nashville, TN)
- …and policies. + Work with all matrix partners to ensure accurate and timely processing of Medicare Appeals . + Read Medicare guidance documents report and ... Requirements include, but not limited to:** + Must have experience in Medicare Appeals , Utilization Case Management or Compliance in Medicare Part C + Ability to… more
- CVS Health (Columbus, OH)
- …findings, regulations, and legislation, employing all tools associated with claims and appeals processing to mitigate risks. + Employs expert knowledge of ... as Leadership. **Required Qualifications** + Prior experience as a Complaint and Appeal Analyst . + Must have experience processing health insurance grievance and… more
- US Tech Solutions (Columbia, SC)
- …to work remote. Equipment will be provided. + Prefer 2 yrs. UM and/or appeals experience. We want to see all candidates with experience with prior insurance, ... regulations or standards. Performs thorough research of the substance of service appeals by both member and provider based on clinical documentation, contractual… 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...member will assign the incoming concern to the appropriate analyst and may assist in investigations, documentation gathering, and… more
- LA Care Health Plan (Los Angeles, CA)
- Appeals & Grievances Regulatory Audit Readiness Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, ... auditing strategy for the following end-to-end processes within CSC (ie Enrollment processing timeliness and accuracy of loading members, timeliness of ID Card and… more
- The Cigna Group (Nashville, TN)
- … appeals and related issues, implications and decisions. The Case Management Analyst reports to the Supervisor/Manager of Appeals and will coordinate and ... as well as Part B drugs. The Case Management Analyst will be responsible for analyzing and responding appropriately...with all matrix partners to ensure accurate and timely processing of Medicare Appeals . + Read Medicare… more
- City and County of San Francisco (San Francisco, CA)
- …+ Key duties include preparing candidate friendly job advertisements, processing job applications, and constructing, administering, and scoring examinations. ... within, and/or leave the City workforce. + Key duties include processing new hires through interviews and onboarding activities, facilitating employee transfers,… more
- TEKsystems (Tampa, FL)
- …person will be on the bill review team specifically working in the backlog of appeals . + The Bill Review Analyst position holds accountability for accurate and ... Claims Analyst In-Office: Tampa, FL 33609 Pay Rate: $23/hr Anticipated...timely review, processing and payment of bills to include pre-coding accuracy and… more
- State of Colorado (Denver, CO)
- …or knowledge of the action: Colorado State Personnel Board/State Personnel Director, Attn: Appeals Processing , 1525 Sherman Street, 4th Floor, Denver, CO 80203. ... Senior Legislative Performance Auditor/ Analyst I Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4811528) Apply Senior Legislative Performance… more