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Prepare and submit appeals to insurance companies, including supporting documentation and medical records. Track the status of appeals and follow up with insurance companies as needed. Vaco values a diverse workplace and strongly encourages women, people of color, LGBTQ+ individuals, people with disabilities, members of ethnic minorities, foreign-born residents, and veterans to apply.
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The Strategy Director supports Government Business Grievances & Appeals and Government Business Enrollment Billing. Business knowledge in Government Health Benefits to include Grievances & Appeals and/or Enrollment Billing preferred.
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Exercise sound managerial judgment and decision-making pertaining to all employee relations and personnel actions (i.e., timely performance evaluations, grievance handling, disciplinary actions, employee counseling, etc.
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The right candidate for this position will have a degree in Human Resources, Employee Relations or a related field and experience responding to employee issues, managing labor relations, facilitating the grievance process, and conducting investigations.
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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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Serve as member of Labor-Management committee and as a hearing officer in disciplinary and grievance proceedings; PHR/SPHR, SHRM-CP/SHRM-SCP certification preferred. OTHER: The candidate must possess and maintain a valid driver’s license in state of residence, and maintain an insurable driving record under the terms and conditions of the CMHA auto liability policy.
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Submit appeals and documentation regarding vocational rehabilitation eligibility, Medical Hold eligibility, LMWL eligibility and Rehab Recommendations to the BWC Rehabilitation Appeals Unit. Works to resolve issues that may cross over into medical case management with the assigned case management person.
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Implement and execute appropriate restaurant level financial controls (petty cash, profit and loss statements, daily deposits, WebCEMS, payroll, NOI reports, budget book, EOD reports, etc.) Restaurant General ManagerAbout Us Carrols Corporation is one of the largest restaurant companies in the U.S. and is headquartered in Syracuse, New York. Carrols owns and operates more than 800 restaurants under the BURGER KING brand with plans for continue growth.
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SKILLS & ABILITIES : Thorough understanding of Employment and Labor Law (Ohio public sector preferred) Proficient in the MS Office (or similar) suite, including, but not limited to, Excel, Word, Access and PowerPoint; GroupWise email; Maximo (or similar) inventory management and purchasing modules.
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Job duties will include being chief spokesperson for negotiating collective bargaining agreements, including mediation, fact-finding and conciliation, preparing materials and data to support the position of the membership, facilitating labor/management relations, representing our members in grievance arbitration hearings, internal investigations, and other disciplinary matters.
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Develop methods to identify patient reimbursement issues, ensure claims, denials, and appeals are efficiently processed, and resolve billing-related issues. Must have good organizational skills and work professionally with doctors, hospital administration and management, SEP associates and the public.
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A Tax Manager, Business Incentives Group (BIG) in BDO’s Specialized Tax Services (STS) business is responsible for helping clients identify, document, and support tax positions related to this specialty’s area of tax law upon examination and at appeals.
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The manager will be responsible for managing Underpayments, Manage underpayment vendor, insurance credit balances, Refunds, Epic pricing issues, Run Business intelligence reports, Manage underpayment vendor, Appeals and Inpatient appeal follow up with a focus on quality, productivity and results.
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Serve as the trial attorney for HCJFS by attending and participating in all stages of the court proceedings including: preliminary protective hearings; pretrial, adjudication, disposition and post-disposition hearings; review and annual review hearings; motions to set aside and objection hearings; and appeals.
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As the first of its genre in the market, Hotel Covington appeals to business and leisure travelers accustomed to upscale hotels in primary markets seeking an authentic and locally influenced experience.
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grievance appeals jobs in Cincinnati, OH
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