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Serves as the Senior Plan leader and liaison for MHI Service Operations, including: Claims, Configuration Information Management, Enrollment, Contact Center Operations, IT, Provider Configuration Management, Program Integrity, Risk Adjustment, Provider Resolution Team, Provider Appeal and Grievances, Member Appeals and Grievances, and other departments as required.
$122,430.44 - $238,739.34 a yearExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Assisting in preparing appeals, impartial medical reviews, rebuttals, and coordinates the assignment of Service member's legal counsel. Serving as a liaison between the Service member, their respective commander and a multi-disciplinary team of primary care managers, other appropriate health care professionals, medical care case managers, non- medical case managers, patient administration personnel, the service-specific offices, the PEB and the Military Department Wounded Warrior Program liaison or advocate.
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Monitors unemployment claims and assists departments with appeals, performance appraisal programs, Workers’ Compensation claims, and posting of position announcements, interview processes, and selection of employees.
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Description & Requirements Maximus is seeking a Coordinator 2 Appeals. This is a fully remote position. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances.
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Vacancies will be filled in the following specialty areas: Office of Appeals Shared Administrative Support. 42 Vacancies- Will befilled in any Appeals location listed within this announcement.
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Oversees annual giving functions, including giving days, unit-based appeals, parent appeals, faculty/staff/retiree appeals, crowdsourcing, student callers, and related activities.
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All pertinent federal, state, and local permitting, enforcement, and appeals processes as it relates to environmental compliance issues. Bachelor's degree from an accredited college or university in environmental health or science, public health administration, or engineering;and.
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Additionally, you may serve as an instructor or argue appellate cases before the Navy-Marine Corps Court of Criminal Appeals or the United States Court of Appeals of the Armed Forces. While you will most likely serve as a trial counsel (prosecutor) or defense counsel in military courts-martial during your first tour, you will also have the opportunity during your career to practice law as a Staff Judge Advocate (in-house counsel) in areas as diverse as: operational law, family law, environmental law, fiscal law, labor law, cyber law, and international law.
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Has knowledge and experience to prepare appellate briefs and argue cases before the Court of Appeals and for Supreme Court. Provide professional legal services representing juvenile and adult indigent clients, handle highly complex appeals or serve as lead counsel for serious violent felony or appeals and other highly complex litigation cases.
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Manage all appeals and grievance concerns and priorities within the UHC Turquoise Care Population. Obtain relevant medical records to submit appeals or grievance for additional review, as needed.
Full-timeRemoteExpandApply NowActive JobUpdated 19 days ago - UpvoteDownvoteShare Job
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Responsible for the oversight of 4 departments, and growth of directors and associate director, fully developing leaders of leaders: Case Management, Disease Management / Personal Nurse, Utilization Management / Appeals, and Experience and Optimization team.
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Three years of experience in nursing, experience with insurance claims/appeals and CPT code knowledge. Evaluate prior authorization requests for medical necessity and review medical records for insurance appeals.
Full-timeRemoteExpandApply NowActive JobUpdated 21 days ago - UpvoteDownvoteShare Job
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Respond to written inquiries and appeals in a timely and professional manner. One (1) year experience in public relations or customer service, preferably in the group benefits/insurance field.
Starting at $15.5 an hourFull-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Assist billing personnel with preparation of denials and submitting appeals for payment. Interface with insurance companies and other payors on prior authorization and referral requests, abstract charts and assign CPT, ICD and HCPCS codes for purposes of obtaining prior authorization.
$16.32 - $23.84 an hourPart-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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This will involve providing quality control checks on paper claims; processing tracers, denials and related correspondence; initiating appeals; and drafting, composing, and submitting appeal letters.
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appeals job in Albuquerque, NM
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