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Acentra is currently looking for a Utilization Management Appeals Nurse – LPN/RN to join our growing team. Our Utilization Management Appeals Nurse – LPN/RN will help orchestrate the seamless resolution of appeals in line with health regulations.
$24 - $35 an hourFull-timeExpandApply NowActive JobUpdated 3 months ago - UpvoteDownvoteShare Job
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As an Inpatient Appeals Audit Coder with Parallon you can be a part of an organization that is devoted to giving back! We are looking for an enthusiastic Inpatient Appeals Audit Coder to help us reach our goals.
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Job Title:Grievance and Appeals Coordinator 1. Must have previous Grievance and Appeals exp. Job Title:Grievance and Appeals Coordinator 1. Must have previous Grievance and Appeals exp. Location: Remote/Hybrid - must be local to Woodland Hills, CA.
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Creating scalable processes and mechanisms that sync with other internal support teams (e.g., customer support, seller support, account managers) to ingest, assign and initiate investigations (and appeals) quickly without sacrificing quality.
Full-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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We enjoy the closeness, directness, and efficiency of working in a small company environment Anthem Engineering is an EEO employer. DevOps engineer roles and responsibilities include providing expertise in the full system development lifecycle, from concept and design to testing, delivery, and sustainment.
Full-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Maintains updated knowledge of project and corporate policies and procedures as referenced in the employee manual and other desk procedures for the position
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Our Talent Acquisition team is reviewing applications for our Sr Appeals Analyst opening. You will serve as subject matter expert in the payer appeals resolution process. We are looking for a dedicated Sr Appeals Analyst like you to be a part of our team.
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Review and evaluate appeals and grievance requests to identify and classify member and provider appeals, hand-off to appropriate department for provider and clinical appeals; process member and provider complaints as appropriate to meet the CMS, State and Accreditation requirements.
ExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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In close collaboration with Denver Labor’s Executive Director and other team members, the Policy and Appeals Manager will serve a crucial role. The Policy and Appeals Manager will also collaborate with other staff to conduct administrative rulemaking, determine enforcement policies, set strategic enforcement goals, issue determinations, and provide legal and analytical support for wage theft and retaliation investigations.
$111,920 - $143,210 a yearFull-timeExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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Maintain the integrity of the appeals and denials tracker. Must have experience in Medical Appeals, Grievance, Utilization Case Management. Summary: The Appeals and Denials Nurse coordinates actions related to all denials and appeals.
Part-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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Claims Appeals Representative \ Remote. 3 years Billing collections, or denials management experience and medical terminology. 3 years Familiarity with managed care contracting, provider operations and/or payer operations.
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The Appeals Coordinator shall be responsible for supervising the credentials appeals work of the State Board of Examiners. The Appeals Coordinator shall be responsible for supervising the credentials appeals work of the State Board of Examiners.
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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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Appeals would be written if related to deaths, AMAs, auths due to payer error or when already received. ECU Health Medical Center, one of four academic medical centers in North Carolina, is the 974-bed flagship hospital for ECU Health and serves as the primary teaching hospital for The Brody School of Medicine at East Carolina University.
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Under the supervision of the Appeals and Grievance Manager, assist with soliciting non-clinical information from Participating Physical Group (PPG) and specialist concerning follow care related to care management.
$47,840 - $68,474 a yearFull-timeExpandApply NowActive JobUpdated 8 days ago
Title: appeals Company: Anthem
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