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Complaints & Appeals Editor jobs

Viewing 1 - 10 of 81 jobs

  • Appeals Team Lead

    Meridian Health Plan - Detroit, MI

    investigating, negotiating and resolving all types of appeals * Communicates with appropriate parties, issues, ... and State Director of Operations with the member complaints * Updates Pharmacy and Behavioral Health...

    30+ days ago from Meridian Health Plan

  • Appeals Representative –

    UnitedHealth Group - Phoenix, AZ

    researching, investigating, and triaging all types of appeals and grievances. Communicates with appropriate ... business needs required Assets: Medicaid/Medicare Appeals and Claims experience is highly preferred Familiarity...

    17 days ago from United Health Group

  • Paralegal, Enforcement

    Finra - Woodbridge, NJ

    and process legal documents such as briefs, pleadings, appeals, and contracts. This is junior-level professional work ... as summaries, motions, records, exhibits, briefs, and complaints for the review, approval, and use by legal staff. *...

    24 days ago from FINRA

  • Patient Acct Rep-Med Grp

    Intermountain Healthcare - West Valley City, UT

    collects past due amounts, deals with patient concerns / complaints, sets up budget plans, processes financial ... from carriers and makes appropriate adjustments. Works appeals and denials with insurance companies. * 3. Reports *...

    1 day ago from Intermountain Healthcare

  • Program Integrity Manager

    Hewlett Packard - Chicago, IL

    direction to the ZPIC in the area of investigations and complaints, and may entail providing direction to the other ... integrity manager (PI) may monitor edit effectiveness, appeals and workload metrics for compliance with CMS...

    25 days ago from Hewlett Packard

  • Provider Claims Service Rep - (P)

    AmeriHealth - Jacksonville, FL

    and/or responds to inquiries, dissatisfactions, complaints and grievances. Documents all calls in inquiry tracking system. Using established protocols ensures resolutions provided are presented in a clear and accurate manner. Facilitates...

    4 days ago from AmeriHealth

  • Customer Support Supervisor

    Dow Jones - Princeton, NJ

    team and first line team to identify customer complaints to log and escalate as required To report on the performance of ... skills Ability to deal with High level complaints Experience supporting a sales team desired Ability to prioritise...

    10 days ago from Dow Jones

  • Patient Account Rep II (Special Billing-Transplant Follow Up)

    Stanford Hospital & Clinics - Palo Alto, CA

    collections and payer follow-up, Payer denial review and appeals processing, Customer service, Payment applications, ... guidelines and resolve payment with payer. Perform appeals with payer. Performs bad debt request transfers as...

    14 days ago from Stanford Hospital & Clinics


    Brigham and Women's Hospital - Boston, MA

    in PCS the standing of the claim. • Resolve claims appeals. Once a claim is denied and a appeal is appropriate, appeals ... must have have a clear understanding of the entire appeals process from start to finish and also be able to work...

    17 days ago from Brigham and Women's Hospital

  • Front Office Manager

    Holiday Inn Express & Suites Dallas North Tollway - Plano, TX

    to ensure complete guest satisfaction. Respond to guest complaints or concerns in a prompt and professional manner. Comply with federal, state and local laws regarding health, safety and alcohol services Foster positive owner relationships...

    1 day ago from