- Healthfirst (NY)
- Duties and Responsibilities + Responsible for case development and resolution of non - clinical cases, such as: certain types of claim denials, member complaints, ... and member and provider appeals . The end-to-end process requires the Specialist to independently: + Research issues + Reference and understand HFs internal health… more
- Kelsey-Seybold Clinic (Pearland, TX)
- **Responsibilities** This role actively manages all Medicare reconsiderations, grievances , and appeals , adhering to company policies and CMS regulatory ... the primary liaison for the CMS regional office regarding appeals , grievances , and complaints, this individual diligently...quality patient care by adding to our team of clinical and non - clinical professionals that… more
- Elevance Health (Columbus, GA)
- …position in the NGS Appeals Department that reviews analyzes and processes non -complex pre-service and post-service grievances and appeals requests from ... and multiple products, (Part A & B) related to clinical and non - clinical services, quality...will make an impact:** + Reviews analyzes, and processes non -complex grievances and appeals by… more
- Elevance Health (Las Vegas, NV)
- …the Enterprise Grievance & Appeals Department that reviews, analyzes and processes non -complex pre service and post service grievances and appeals ... HMO, POS, PPO, EPO, CDHP, and indemnity) related to clinical and non clinical services,...make an impact:** + Reviews, analyzes and processes non -complex grievances and appeals in… more
- Elevance Health (Wallingford, CT)
- …the Enterprise Grievance & Appeals Department that reviews, analyzes and processes non -complex pre service and post service grievances and appeals ... HMO, POS, PPO, EPO, CDHP, and indemnity) related to clinical and non clinical services,...make an impact:** + Reviews, analyzes and processes non -complex grievances and appeals in… more
- University of Utah Health (Salt Lake City, UT)
- …and set goals for staff workloads. + Ensure that staff are processing Grievances and Appeals efficiently and in compliance with applicable policies, regulations, ... and requirements. + Provide education to staff and other departments on Appeals and Grievances . + Develop process improvement initiatives, including initiatives… more
- State of Colorado (Arapahoe County, CO)
- CORRECTIONAL, YOUTH, OR CLINICAL SECURITY SUPERVISOR III - Marvin W. Foote YSC - Englewood, CO Print ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4797351) Apply CORRECTIONAL, YOUTH, OR CLINICAL SECURITY SUPERVISOR III - Marvin W. Foote YSC -… more
- State of Colorado (Lakewood, CO)
- CORRECTIONAL, YOUTH, OR CLINICAL SECURITY OFFICER II - Betty K Marler YSC - Lakewood, CO Print ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4811880) Apply CORRECTIONAL, YOUTH, OR CLINICAL SECURITY OFFICER II - Betty K Marler YSC - Lakewood,… more
- University of Utah Health (Salt Lake City, UT)
- …across Utah. This coordinator role will work with reports/claims data, assist with appeals and grievances , and ideally requires experience with health plans and ... Microsoft Excel and Microsoft PowerPoint. + May assist with medical discount program appeals , open negotiations and grievances . + Provides support to upper level… more
- Sharp HealthCare (San Diego, CA)
- …regard to Plan policy as needed.Completes and/or supervises the completion of all clinical appeals and grievances . Collaborates with Customer Care Manager ... a lead medical manager and policy advisor to SHP clinical and its' Chief Medical Officer. **Required Qualifications** +...normal working hours for inquiries and authorization requests for non -urgent health care services. + Performs other duties as… more