- Genesis Healthcare (Philadelphia, PA)
- …a comprehensive analytical review of patient's medical records. Appeal Writer/ Reimbursement Analyst will write sound, sensible and factual arguments that clearly ... guidance for appeal requests at all levels.Maintains tracking records of appeals management activities in accordance with department policiesPerforms other duties as… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Nurse Specialist RN II Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, ... achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Nurse Specialist Registered...benefits including + Paid Time Off (PTO) + Tuition Reimbursement + Retirement Plans + Medical, Dental and Vision… more
- St. Mary's Healthcare (Amsterdam, NY)
- …and audit requests and coordinates attempts to overturn denials by drafting appeals , negotiating with payers, or following up with payer utilization review ... * Collaborates with managed care department to code billable items for reimbursement . Collaborates with appropriate staff to secure information for billable items. *… more
- VNS Health (Manhattan, NY)
- OverviewManages the day to day activities for staff handling of grievances and appeals for one of the following VNS Health Plans product lines - Managed Long Term ... and audits subcontractors who have delegated responsibility for managing grievance and appeals on behalf of the plan to ensure operational and regulatory compliance.… more
- VNS Health (Manhattan, NY)
- OverviewResolves grievances, appeals and external reviews for one of the following VNS Health Plans product lines - Managed Long Term Care (MLTC), Medicare Advantage ... appeal decision. Develops correspondence communicating the outcome of grievances and appeals to enrollees and/or providers. Assists with collecting and reporting… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Appeals and Grievances Clinical Operations RN Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 ... safety net required to achieve that purpose. Job Summary The Supervisor of Appeals and Grievances Clinical Operations (A&G) RN is responsible for executing the… more
- Carle (Urbana, IL)
- Outpatient Denial/ Appeals Specialist- RN + Department: Revenue Cycle - CFH_10_19 + Entity: Champaign-Urbana Service Area + Job Category: Clerical/Admin + Employment ... The Fields + Weekend Requirements: no + Other Posting Information: Registered Professional Nurse (RN) License Illinois upon hire. + Holiday Requirements: no Email a… more
- BronxCare Health System (Bronx, NY)
- …in the analysis and preparation of responses to payor denials and develop strong appeals for the purpose of securing reimbursement for acute care services ... identification of patterns and trends identified during the course of appeals preparation. Conduct departmental performance improvement audits, analyze findings and… more
- Henry Ford Health System (Troy, MI)
- …prompt and thorough investigation of medical, transportation, and pharmacy member appeals and grievances for Health Alliance Plan's (HAP's): Commercial, Medicare ... + Conduct the primary investigation and resolution of member appeals and grievances following established guidelines from: The Center...two (2) years of experience as a Licensed Practical Nurse (LPN) in the State of Michigan preferred. +… more
- State of Colorado (CO)
- CDOC Nurse Supervisor Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4383689) Apply CDOC Nurse Supervisor Salary $8,204.00 - $11,487.00 ... Monthly Location Statewide, CO Job Type Full Time Job Number CAA Nurse III 2/2024 Department Department of Corrections Division Clinical and Correctional Services… more