Senior Administrative Appeals Specialist

Job Title: Senior Administrative Appeals SpecialistLocation: NY Pittsford (NSA)Job Summary: Integrated Resources is seeking a detail-oriented and knowledgeable Senior Administrative Appeals Specialist to join our team. As a key member of our team, you will be responsible for maintaining updated knowledge of project and corporate policies and procedures. Your...

Job SummaryWe are seeking a highly skilled Senior Specialist, Clinical Denials and Appeals to join our team at NYU Langone Health. This role will be responsible for coordinating the daily workflow of the Appeal Writers across all NYU Langone campuses, analyzing denials, and identifying opportunities for process improvement and revenue protection.Key...

Job SummaryWe are seeking a highly skilled Senior Specialist, Clinical Denials and Appeals to join our team at NYU Langone Health. This role will play a critical part in the overall coordination of daily workflow to the Appeal Writers for all NYU Langone campuses.Key ResponsibilitiesDevelop and implement Standards of Practice for Clinical Denials and Appeals...

Job Title: Sr. Admin AppealsJob Summary: Integrated Resources is seeking a detail-oriented and knowledgeable individual to join our team as a Federal No Surprise Act Sr. Admin. This role will be responsible for maintaining updated knowledge of project and corporate policies and procedures, functioning as a Subject Matter Expert in one or more process areas,...

Job SummaryWe are seeking a highly skilled Grievance and Appeals Specialist to join our team at EmblemHealth. As a key member of our organization, you will be responsible for responding to written and verbal grievances, complaints, appeals, and disputes submitted by members and providers in accordance with regulatory requirements.Key...

Job SummaryWe are seeking a highly skilled Pharmacy Technician, Appeals Specialist to join our team at Capital Rx. As a Pharmacy Technician, Appeals Specialist, you will play a critical role in ensuring the efficient and effective processing of appeals and prior authorizations for our clients.Key ResponsibilitiesReview and process appeals and prior...

Job Summary:We are seeking a highly skilled Pharmacy Technician to join our Appeals team. As a Pharmacy Technician, Appeals Specialist, you will be responsible for reviewing and processing appeals for our clients. This is a critical role that requires strong attention to detail, excellent communication skills, and the ability to work independently in a...

Job SummaryWe are seeking a highly skilled Pharmacist to join our team as a Prior Authorization and Appeals Specialist. In this role, you will be responsible for reviewing clinical coverage determinations and appeals for various lines of business, including Commercial and Medicare. You will work closely with internal and external Medical Directors to provide...

Job Title: RN Appeals NurseAt VillageCare, we are seeking a highly motivated and detail-oriented RN Appeals Nurse to join our team. As a key member of our Utilization Management team, you will play a critical role in conducting comprehensive analytic reviews of clinical documentation to support authorization decisions and appeal determinations.Key...

Job SummaryWe are seeking a skilled RN- Appeals and Denials Specialist to join our team at SSM Health. As a key member of our System Care Coordination department, you will play a critical role in reviewing, assessing, and completing denial management activities.ResponsibilitiesScreen denials for possible reconsideration, peer to peer, or formal...

Job SummaryWe are seeking a skilled RN- Appeals and Denials Specialist to join our team at SSM Health. As a key member of our System Care Coordination department, you will play a critical role in reviewing and assessing denial management activities.ResponsibilitiesScreen denials for possible reconsideration, peer to peer, or formal appeal.Collaborate with...

About the RoleWe are seeking a highly skilled and detail-oriented Grievances and Appeals Representative to join our team at Humana. As a key member of our healthcare services team, you will play a critical role in ensuring that our members receive the best possible care and support.Key ResponsibilitiesConduct comprehensive analytic reviews of clinical...

Job Title: Appeals Coordinator IIAt MedReview, we are a leading authority in payment integrity solutions, including DRG Validation, Cost Outlier, and Readmission reviews. We are seeking an Appeals Coordinator II to assist our Appeals leadership with daily administrative work within the department.Responsibilities:Prepare and disseminate case files for...

Job Title: Appeals Coordinator IIAt MedReview, we are a leading authority in payment integrity solutions, including DRG Validation, Cost Outlier, and Readmission reviews. We are seeking an Appeals Coordinator II to assist our Appeals leadership with daily administrative work within the department.Responsibilities:Prepare and disseminate case files for...

About the RoleHouston Methodist is seeking a highly skilled Senior Coding Specialist to join our team. As a Senior Coding Specialist, you will be responsible for applying correct coding conventions to patient charge encounters in a clinical environment.Key ResponsibilitiesCommunicate with physicians and Physician Organization Central Business Office (PO CBO)...

Senior Specialist, Clinical Denials & AppealsNYU Langone Health is seeking a highly skilled Senior Specialist, Clinical Denials & Appeals to join our team. As a key member of our Clinical Denials and Appeals team, you will be responsible for analyzing denials that have been concurrently certified and overturned on P2P, identifying and presenting Process...

Job Title: Senior Systems AdministratorWe are seeking a highly skilled Senior Systems Administrator to join our team at Hire With Jarvis. As a key member of our IT department, you will be responsible for providing top-notch technical support to our clients in the NYC area.Key Responsibilities:Supporting clients in-person and remotely to resolve day-to-day...

Job Title: Senior Billing SpecialistCN Guidance and Counseling Services is seeking a highly skilled Senior Billing Specialist to join our team. As a Senior Billing Specialist, you will be responsible for recording all transactions of clients, preparing invoices for claim submission, payment, follow-up, and reconciling all account...

About the RoleWe are seeking a dedicated and compassionate Senior Care Specialist to join our team at Sunrise Senior Living. As a key member of our care team, you will play a vital role in providing exceptional care and services to our residents and their families.ResponsibilitiesBuild Meaningful Relationships: Develop strong bonds with a designated group of...

Job SummaryWe are seeking a highly organized and detail-oriented Administrative Support Specialist to join our team at UIC Government Services and the Bowhead Family of Companies. As a key member of our team, you will provide critical support to our operations by maintaining and organizing files, managing mail, and performing various administrative...