beBeeAppeals Jobs in United States

About the Role: · This position involves facilitating comprehensive research and resolution of appeals using support systems to determine appropriate outcomes. The ideal candidate will have excellent communication skills to contact members/providers via written and verbal communi ...

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About the Role · We are seeking a highly organized individual to join our team as an Appeals and Grievance Coordinator. This is an exciting opportunity to work in a dynamic environment where no two days are ever the same. · You will serve as the primary point of contact for membe ...

Job Summary · This role involves overseeing the Appeals and Grievances Management process to ensure timely resolutions for members, providers, and agencies. · Liaise with team members to manage submissions, interventions, and resolutions for appeals, grievances, and complaints fr ...

Claims Specialist Role Overview: · Provides expert-level research to address appeals related inquiries<P required-skills Required Skills: <strong data-text= ...

Job Title: Specialist, Appeals · We are seeking a highly skilled and detail-oriented Specialist, Appeals to join our team. In this role, you will be responsible for facilitating comprehensive research and resolution of appeals, disputes, grievances. · ...

Cultivate expertise in resolving patient complaints and grievances as an Appeals Representative Associate. · This challenging position involves analyzing trends, applying knowledge/skills to basic activities, research, resolution of written complaints etc. · ...

We're looking for an experienced professional to lead our remote team as a Supervisor. This is a key leadership position responsible for ensuring the successful execution of day-to-day operations. The ideal candidate will have strong problem-solving skills, be able to motivate th ...

Job Description · We are seeking a skilled and detail-oriented professional to join our team in the role of Appeals Nurse. In this position, you will be responsible for examining medical records and claims information, determining medical necessity, and ensuring compliance with M ...

Key Responsibilities: · Facilitate comprehensive research to resolve appeals, disputes, grievances, · and/or complaints from members; · Conduct thorough investigations using support systems to determine appropriate outcomes; · Resolution Outcome Criteria, ensures fair resolution ...

Clinical Appeal Nurses process patient complaints related to medical care in a timely manner. To be successful in this position, one must have excellent analytical skills to review medical records carefully analyze information gathered make well-reasoned decisions regarding patie ...

Evolent seeks nurses to join our appeals team. We aim to make a meaningful impact in the lives of those we serve. · The specialty appeals team focuses on providing excellent care and service while adhering to company policies and procedures. · We strive for collaboration, continu ...

Our team seeks a seasoned Denials and Appeals Specialist · About the Role: · The Denials and Appeals Specialist will be responsible for facilitating the appeals process to ensure revenue recovery of denied claims. · Key Responsibilities: · <ol start= ...

Job Summary · The Lead Specialist, Appeals role entails providing high-level support for claims activities including reviewing and resolving member and provider complaints. · Serves as a team leader for submission, intervention, and resolution of appeals, grievances, and/or compl ...

A healthcare appeals specialist is required for this role. The successful candidate will be responsible for researching and resolving complex issues related to member complaints. They must work closely with both members and providers ensuring all processes meet internal regulatio ...

Job Role Summary · This position involves supporting claims processes, including claim review and resolution of member and provider complaints. · ...

About the Role · Your Key Responsibility · The team responsible for reviewing member appeals and grievances is focused on clinically assessing claims that result from preservice, post-service, or claim denials. As a Medicare Appeals and Grievances RN Lead, you will be accountabl ...

Job Title: · Eligibility Supervisor II · This role is within the Access and Eligibility Services department's Eligibility Operations Integrity Support Services (ISS). The team focuses on appeals and mitigation. · ...

Skill Sets Required for Success: · To excel in this position, you will need to demonstrate a combination of clinical expertise and strong analytical skills. · Key areas of responsibility include: · Developing detailed summaries of denied cases following hospital administration gu ...

Complaints Reviewer Position Overview · The role of the Complaints Reviewer is to provide a thorough review of all complaints received from members or providers regarding claim denials. This involves assessing each case based on its merits and ensuring that it aligns with establi ...