Medicare Appeals Coordinator - Somerville

The incumbent will coordinate, process, and document all aspects of member appeals and grievances across our product offerings. Responsible for documenting and owning the life cycle of all member appeals and grievances and provider appeals. · ...

+The Appeals and Grievance Coordinator will coordinate, process, and document all aspects of member appeals and grievances, · as well as provider appeals across all our product offerings (Commercial, Medicaid and Medicare). · ...

The Appeals and Grievances Coordinator will coordinate process and document all aspects of member appeals grievances as well as provider appeals across all our product offerings Commercial Medicaid Medicare. · Bachelor's Degree Related Field of Study preferred · ...

Join our client's team as an Appeals & Grievances Coordinator and play a vital role in ensuring seamless resolution processes for member grievances and appeals within our innovative health plan. · Manage a high volume of incoming grievances and appeals from initiation to resoluti ...

+Join our client's team as an Appeals & Grievances Coordinator and play a vital role in ensuring seamless resolution processes for member grievances and appeals within our innovative health plan. · +Manage a high volume of incoming grievances and appeals from initiation to resolu ...

The Intake/Appeals Coordinator is responsible for any request of applicant appeal. · This position verifies that the client meets all program requirements and certifies the application for appropriate level(s) of assistance. · Answer phones as needed, · make and file applicant fo ...

The Duals Supervisor Appeals Grievances provides day-to-day supervision of a team of 4-6 appeals and grievance coordinators.• Facilitates regular bi-weekly one-on-one meetings and weekly team staff meetings with the Appeals and Grievances department. · • Identifies training needs ...

The Duals Supervisor, Appeals and Grievances provides day-to-day supervision of a team of 4-6 appeals and grievance coordinators and is ultimately responsible for the work product of this team and the Duals line of business. · The Supervisor oversees all aspects of the Appeal and ...

The Admitting Appeals Specialist is responsible for assisting with insurance denials and adhering to programs, policies, and procedures to maximize reimbursement by minimizing denials. · ...

The Admitting Appeals Specialist is responsible for assisting with insurance denials and adhering to programs, policies, and procedures to maximize reimbursement by minimizing denials. · ...

+ Job Summary · The role leads a team responsible for the processing of all Member Appeals and Grievances for Medicaid and Commercial product lines. · + Qualifications:Bachelor's Degree or the equivalent combination of training and experience required · + ...

The Insurance Support Nurse participates in the timely management of denials that are received in the Care Coordination Department. Through sound knowledge of utilization management, the nurse is able to assess a patient's level of care after review of the medical record. · For n ...

The Insurance Support Nurse participates in the timely management of denials that are received in the Care Coordination Department.Through sound knowledge of utilization management, the nurse is able to assess a patient's level of care after review of the medical record. · ...

The Insurance Support Nurse participates in the timely management of denials that are received in the Care Coordination Department. Through sound knowledge of utilization management, the nurse is able to assess a patient's level of care after review of the medical record. · For n ...

Job Summary · The Insurance Support Nurse participates in the timely management of denials that are received in the Care Coordination Department.Through sound knowledge of utilization management, the nurse is able to assess a patient's level of care after review of the medical re ...

The Insurance Support Nurse participates in the timely management of denials that are received in the Care Coordination Department.Through sound knowledge of utilization management, the nurse is able to assess a patient's level of care after review of the medical record. · ...

The role leads a team responsible for the processing of all Member Appeals and Grievances for Medicaid and Commercial product lines. · Oversight includes appeal and grievance intake, investigation, and resolution. · Create systems and procedures for operating efficiency. · ...

We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. · Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a ...

Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. · We are pleased to offer competitive salaries and a benefits package with flexible work options, · This role will coordinate process investigate document all aspects of member complaints ...

The Claims Operations Manager is responsible for managing commercial claims operations to ensure efficient and accurate processing of claims. Oversees claims workflows, compliance, and team performance to support revenue cycle goals and optimize reimbursement processes. · ...