Appeals analyst jobs in United States

Company : · Highmark Inc.Job Description :  · JOB SUMMARY · This job reviews inquiries to determine if they meet the definition of a grievance/appeal; documents, investigates, refers and coordinates grievances and appeals; initiates a case file for each grievance and appeal; ensu ...

This job reviews inquiries to determine if they meet the definition of a grievance/appeal; documents investigates refers and coordinates grievances and appeals initiates a case file for each grievance and appeal ensures compliance with organizational and regulatory requirements f ...

Company : · Highmark Inc.Job Description :  · JOB SUMMARY · This job reviews inquiries to determine if they meet the definition of a grievance/appeal; documents, investigates, refers and coordinates grievances and appeals; initiates a case file for each grievance and appeal; ensu ...

Job Details for Appeals Case Manager · Court Name/Organization · Tenth Circuit Court of Appeals · Overview of the Position · The Clerk's Office of the U.S. Court of Appeals for the Tenth Circuit is seeking candidates for the position of Case Manager. The Clerk's Office is the cas ...

Piper Companies is recruiting a Clinical Appeals Analyst to support a prominent organization within the health insurance industry. · Performing clinical reviews for member and provider appeals in compliance with state federal and accreditation standardsServing as a clinical resou ...

Under the general direction of the Member Appeals and Grievance Supervisor the Member Appeals and Grievance Analyst is responsible per State and Federal regulations for the professional and compliant management and coordination of assigned member appeals and grievance (complaints ...

We are currently looking for an Appeals and Grievance Analyst to join our team at Point32Health. As an Appeals and Grievance Analyst you will be responsible for managing member appeals and grievances in accordance with State and Federal regulations. · You will work collaborativel ...

The Member Appeals and Grievance Analyst is responsible for the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. · This individual works collaboratively with the member and/or the member's auth ...

The Clinical Appeals Analyst is responsible for assisting the Corporate Director of Appeals Management by conducting a comprehensive analytic review of clinical documentation and complete the appeal process. · Review patient medical records and utilize clinical and regulatory kno ...

We are searching for an Appeals & Grievances Analyst to join our team. This role is responsible for managing and resolving member and provider appeals and grievances in strict compliance with CMS regulations and organizational policies. · ...

Under the general direction of the Member Appeals and Grievance Supervisor the Member Appeals and Grievance Analyst is responsible per State and Federal regulations for the professional and compliant management... · Analysts routinely interact with members about highly escalated ...

Under the general direction of the Member Appeals and Grievance Supervisor the Member Appeals and Grievance Analyst is responsible per State and Federal regulations for the professional and compliant management and coordination of assigned member appeals and grievance (complaints ...

The Appeals Analyst is responsible for analyzing assessment appeals in Cook County. This position makes complex decisions to ensure fair and uniform property assessment. · ...

The Member Appeals and Grievance Analyst is responsible for the professional and compliant management · and coordination of assigned member appeals · and grievances received by Point32Health.This individual works collaboratively with the member · and/or the member's authorized r ...

Who We Are · Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to prov ...

Job summaryUnder the general direction of the Member Appeals and Grievance Supervisor appeals analyst responsible per State and Federal regulations for professional management coordination of assigned member appeals grievances received by Point32Health. · ...

The Appeals Analyst role at Point32Health involves professional management and coordination of member appeals and grievances under State and Federal regulations. This position requires superior customer service skills, benefit interpretation knowledge, and ability to work indepen ...

Under the general direction of the Member Appeals and Grievance Supervisor the Member Appeals and Grievance Analyst is responsible per State and Federal regulations for the professional and compliant management and coordination of assigned member appeals and grievance (complaints ...

Denials and Appeals Analyst · Singing River Health System Administrative Building - Gautier | Full-Time | Monday-Friday 8:00am-4:30pm | · 2101 US-90 · Gautier, Mississippi · United States · Position Overview · The Denials and Appeals Analyst assists in the recovery of Health Sy ...

Under the general direction of the Member Appeals · and Grievance Supervisor the Member Appeals · and Grievance Analyst is responsible per State · and Federal regulations for the professional · and compliant management coordination of assigned member appeals · grievances recei ...