- UpvoteDownvoteShare Job
- Suggest Revision
Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within their scope. May also engage in grievance and appeals reviews.
ExpandUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
The Appeals and Denials Specialist is responsible for triaging and writing DRG downgrades and clinical validation appeal letters for multiple clients. The Appeals and Denials Specialist will ensure appropriate action is taken within appeal deadlines.
ExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
- Suggest Revision
The Claims Supervisor is responsible for the day-to-day management of the Senior Analyst claims team, who handle a variety of tasks including, but not limited to, Customer emails, Correspondences, Grievance and Appeals, HRA, Balance Bills and Transplants, enabling the team to deliver exceptional service to our customers.
ExpandUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Independent Office of Appeals: SPECIALIZED EXAM PRGRMS & REFERRALS (SEP&R) 1 position will be filled in the Independent Office of Appeals: SPECIALIZED EXAM PRGRMS & REFERRALS (SEP&R), Area 11, Team 2.
InternExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Assist in complex trials and in appeals before the Supreme Court of Appeals. Assist in complex trials and in appeals before the Supreme Court of Appeals. This position will serve under the direction of the department general counsel and the Bureau for Social Services Commissioner.
Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
The WV Bureau for Social Services is seeking a General Counsel! Assist defense counsel representing the agency in administrative hearings and circuit courts. Advise agency staff on the interpretation and impact of court opinions and statutes, the application of state rules and federal regulations, and the related proper course of action.
Full-timeExpandUpdated Yesterday - UpvoteDownvoteShare Job
- Suggest Revision
Vacancies will be filled in the following specialty areas: Office of Appeals Shared Administrative Support. 42 Vacancies- Will be filled in any Appeals location listed within this announcement.
ExpandUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Job Description - Senior Appeals Specialist-Medicare Advantage (2400193) Senior Appeals Specialist-Medicare Advantage - ( 2400193 ) · 5 years as an Appeals Specialist or equivalent experience in health insurance claims, customer service, billing, or related operations preferred.
ExpandUpdated 3 days ago - UpvoteDownvoteShare Job
- Suggest Revision
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.
ExpandUpdated 5 days ago - UpvoteDownvoteShare Job
- Suggest Revision
You will perform advanced and complex legal work as a staff specialist and function as the principal attorney for the bureau. Review legal pleadings or briefs on complex cases or regulatory issues. Review policies and procedures to ensure alignment with relevant statutes.
ExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
If acting in the capacity as a clinical pharmacist the incumbent may also review UM requests; provide consultation into the case and disease management identification process, and consult with the Organization's Associate Medical Directors and Medical Directors when appropriate, follow-up on appeals in accordance with our regulatory guidelines.
ExpandUpdated 8 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Makes medical necessity determinations for grievance and appeals appropriate for their specialty. Makes medical necessity determinations for grievance and appeals appropriate for their specialty.
ExpandUpdated 8 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Candidates should have experience working in a law firm or legal office with pleadings, discovery, depositions, motions, briefs, and appeals. Candidates should have experience working in a law firm or legal office with pleadings, discovery, depositions, motions, briefs, and appeals.
Full-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Education:Must have admission to practice law in the State of West Virginia. Review various legal instruments for adequacy and appropriateness and revise standard legal documents as necessary. Substitution:One (1) year of experience as an attorney with the State of West Virginia shall be considered equivalent to two years of experience.
ExpandUpdated 9 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Experience:Five (5) years of experience practicing law. Other related work as required.
ExpandUpdated 8 days ago
appeals job in Charleston, WV
FEATURED BLOG POSTS
Is There a Slow Decline of the Labor Market and Wage Growth?
BLS data from January 2023 to March 2023 states that,
2023 Quarterly Review: What’s Happening in Recruitment?
It’s that time again. It’s your quarterly review. Get excited because this is a great time to review some of the amazing accomplishments you and other pros like you have made in recruitment for 2023 thus far! Despite recruitment challenges, things are starting to balance out in the candidate market - partly because of the brilliant ideas and methods being used.
How To Decorate a Cubicle for Inspiration & Productivity
You know the negative reputation cubicles have – dull, dreary, gray. How can you possibly be expected to sit in one every day and be your naturally productive, enthusiastic, and upbeat self? The answer lies in decorating your cubicle so it sparks creativity and feels welcoming. While this might seem impossible given the bland canvas you have to work with, take heart because it’s totally doable!
Project Coordinator Resume Guide with Tips and Samples
Project coordinators fall within the field of project management, which tends to be a field with a lot of opportunity. In short, project coordinators differentiate themselves from project managers due to the responsibilities related to their work. While project managers have a hands-on approach for managing a team, project coordinators ensure the success of a project from the background. They handle administrative and organizational tasks related to delegation, establishing project objectives, or performing digital administrative tasks.
Land a Production Supervisor Job With These 5 Resume Tips
Have you been working as a team lead on a factory floor or in a manufacturing plant for several years? Do you consider yourself a leader who excels at managing and coaching others? Can you monitor and optimize production processes? Do you recognize the importance of employee safety and compliance? If you’re answering yes to all of these questions, then you’re definitely in the right place.
Assistant Manager Resume Guide
It can be very challenging for many individuals to find a job in the current economy. As a result, the unemployment rate is only starting to decrease after being at its highest since the Great Depression. One of many reasons this is occurring is because this pandemic has encouraged people to quit their jobs to search for better working conditions, become entrepreneurs, or change careers.
The Ins and Outs of Building a Resume From a Bar Manager Job Description
Many people turn their noses up at bartending jobs, as they do for most jobs in the food service industry. Little do they know, bartenders possess a lot of unique skills. Even though these jobs can require little to no education, bartenders must go through extensive training or schooling. Additionally, the demand for these jobs is extremely high, and the career growth opportunities often bring bartenders into management positions after years of experience.