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Managing case work end to end covering settlements, PIPs, absence management and all aspects of grievance and disciplinaries (investigations, hearings, mediations, appeals, terminations) in line with legal requirements and company policy.
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Position SummaryThe Senior Technician Prior Auth & Appeals will work a rotating call schedule throughout the day to support Clinical Services Representative I, II, and III with complex non-clinical or Prior Authorization questions or calls.
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Ensure both Medicare beneficiaries and providers receive their entitled rights and protections related to financial liability and appeals under the Fee-for-Service (FFS) and Medicare Advantage (MA) Programs.
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At Houston Methodist, the Coding Charges & Denials Specialist is responsible for coordinating and monitoring the coding specific clinical charges and denial management and appeals process in a collaborative environment with revenue cycle management and clinical partners at various Houston Methodist facilities.
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An Outpatient Nursing position will interest you, if running a Medication Clinic and acting as a case manager appeals to you! An Outpatient Nurse will have a Monday through Friday schedule with a rotating weekend schedule (if needed.
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Legal research and drafting of client correspondence, discovery devices, summations, appeals and appellate briefs. Leading law firm is seeking a Workers Compensation Attorney with 2-7 years of experience.
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Oversee the utilization review process, including denials/appeals, pre-authorization, concurrent review, and retrospective review. Oversee the utilization review process, including denials/appeals, pre-authorization, concurrent review, and retrospective review.
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You can make a difference by volunteering in a position that appeals to you and allows you to use your unique skills and talents. Experience developing call volume forecasts and creating call center agent schedules using software program designed for workforce scheduling (e.g. Avaya, AWS and Verint) for call center operations Experience managing real-time agent staffing by skilling call center agents to achieve call-center operational performance metrics.
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Work with Director of Reimbursement Services to track and report on trends within territory assist hotline staff in addressing coding, coverage, or reimbursement resolutions, appeals for authorization and payment as directed.
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This position is responsible for processing payments, following up on outstanding insurance claims, submitting appeals for denied claims and other various clerical duties. Cardiovascular Medicine is seeking an outgoing individual for an Insurance Specialist opportunity in our Patient Accounts department in Davenport.
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Knowledge of all payors insurance; self-pay after insurance, reimbursements, collections, appeals, claims follow-up and third party billing, required. Manage claim details and verify accurate reimbursement, so as to initiate account adjustments and/or appeals on payment disputes.
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Respond to incoming calls from clients, health plans, providers and enrollees regarding case status, questions about the program, and the appeals process. Admin - Appeals. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances.
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This system is comprised of the Supreme Court of Virginia, the Court of Appeals of Virginia, circuit courts in thirty-one judicial circuits, general district and juvenile and domestic relations district courts in thirty-two districts, and magistrates in offices in thirty-two districts.
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Produce written correspondence for acknowledgements, appeals, and stewardship to convey the impact of donors' contributions. We are hiring a proactive and tech-savvy Development Assistant to join our client's team and work closely with the Development Director.
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Reviews and analyzes Revenue Agent (Examiner), Appeals Officer, and Counsel Attorney instructions, reports, case files, and support statements and interprets tax law court decisions and legal opinions to determine and prepare accurate computations for the most demanding and complex Appeals cases.
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grievance appeals jobs in Davenport, IA
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