Coordinator 2 - Appeals QIC (remote)
2 months ago
General information
Job Posting Title Coordinator 2 - Appeals QIC (remote) Date Tuesday, July 2, 2024 City Remote Country United States Working time Full-time
Description & Requirements
Maximus QIC Appeals (Part A West) has an open position for a Coordinator 2. This is a remote, full-time position with flexible start and end times (8 hrs. per day) during core business hours.Essential Duties and Responsibilities:
Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Conduct fact finding and analyses on those cases deemed complex in nature or requiring adjudication; apply established procedures where the nature of the system, feasibility, computer equipment and reporting tools have not already been decided.
- Track and meet required deadlines for complex cases or other assigned tasks.
- Assist leadership through research of data and/or authoring reports.
- Analyze data using all applicable state law, state regulations, process documents, and other sources as defined by the client contract.
- Work independently on specific situations or on a team to resolve problems and deviations according to current established practices; and obtains advice where precedents are unclear or not available from the client.
- Assist others or provide on-the-job training or act as a mentor to production staff.
- Prior experience with Microsoft Office Suite preferred
- Prior experience with Medicare Appeals and Systems preferred
Home Office Requirements:
- Hardwired internet (ethernet) connection
- Private work area and adequate power source
- All equipment will be provided by Maximus
Minimum Requirements
- High School Degree or equivalent required.
- 2-4 years of related professional experience required.
-
QIC Appeals Specialist
2 weeks ago
Remote, Oregon, United States Maximus Full timeJob Title: Coordinator 2 - Appeals QIC (remote) Company: Maximus QIC Appeals Location: Remote, United States Employment Type: Full-time Overview: As a vital member of our team, the Coordinator 2 will serve as a Subject Matter Expert in designated process areas, ensuring the integrity and accuracy of data related to Independent Medical...
-
Appeals Coordinator 2
1 week ago
Remote, Oregon, United States Maximus Full timeJob Title: Coordinator 2 - Appeals QIC (remote) Company: Maximus QIC Appeals Location: Remote, United States Employment Type: Full-time Overview of Responsibilities:Serve as a Subject Matter Expert in designated process areas.Evaluate data submitted for Independent Medical Review.Perform investigative analysis on intricate cases.Monitor and adhere to...
-
Coordinator 2 - Appeals Management
1 week ago
Remote, Oregon, United States Maximus Full timeJob Title: Coordinator 2 - Appeals QIC (remote) Company: Maximus QIC Appeals Location: Remote, United States Employment Type: Full-time Overview & Responsibilities Serve as a Subject Matter Expert in designated process areas. Evaluate data submitted for Independent Medical Review. Perform comprehensive fact-finding and analysis on...
-
Clinical Appeals Analyst
2 months ago
Remote, Oregon, United States Piper Companies Full timePiper Companies is currently seeking a Clinical Appeals Analyst for a remote opportunity within a highly accredited health insurance organization to complete the analysis, research, and completion of complex appeals. Responsibilities of the Clinical Appeals Analyst:Assess, analyze, and complete non-routine appeals and grievance in order to ensure customer...
-
RN-Appeals and Denials
1 month ago
Remote, Oregon, United States SSM Health Full timeIt's more than a career, it's a callingMO-REMOTEWorker Type:RegularJob Highlights:Department: Care CoordinationSchedule: Full Time, Day Shift, 8:00am-4:30pm; No WeekendsStarting Pay: $67, (Offers are based on years of experience and equity for this role.)Location: Remote**Candidate must live in IL, MO, OK, or WI. If living in MO, OK, or WI, must have...
-
Coding Appeals Specialist
2 days ago
Remote, Oregon, United States Ensemble Health Partners Full timeAbout the RoleWe are seeking a highly skilled Coding Appeals Specialist to join our team at Ensemble Health Partners. As a key member of our coding team, you will be responsible for reviewing and writing appeals for outpatient coding and inpatient Diagnosis Related Group (DRG) denials.Key ResponsibilitiesIntegrate medical coding principles and objectivity in...
-
Social Media Coordinator
2 months ago
Remote, Oregon, United States Advancing Eco Agriculture Full timeDescriptionAbout the CompanyAdvancing Eco Agriculture is a leading company in the regenerative agriculture industry, dedicated to improving the health of our planet and the quality of our food. We develop and promote innovative crop nutrition products and consulting services that help farmers increase yields, improve crop quality, and regenerate their...
-
Laboratory Operations Coordinator
1 week ago
Remote, Oregon, United States Veterans Sourcing Group Full timePosition OverviewLaboratory Operations CoordinatorRemote Opportunity - Eastern Standard TimeContract-to-Hire PositionThis role is fully remote, requiring a self-driven individual with a dedicated home office setup, adhering to Eastern Standard Time.Contract-to-hire arrangement, with potential for earlier conversion.Essential Skills: Proficiency in Microsoft...
-
Account Coordinator
2 months ago
Remote, Oregon, United States Listrak Full timeAbout Listrak:We are a SaaS company that offers an integrated digital marketing platform trusted by 1,000+ leading retailers and brands for email, text message marketing, identity resolution, behavioral triggers and cross-channel orchestration. Our HQ is in Lititz, PA, but we have employees spanning over 30 states (and growing).We are a 350-person...
-
Talent Coordinator
2 months ago
Remote, Oregon, United States NetEase Games Full timeNetEase, Inc. is a global powerhouse in the Internet and video game industry, with a market capitalization of $57+B. We excel in various domains, including internet services, online gaming, e-commerce, and more. Our standout titles like 'Fantasy Westward Journey' and 'Justice' have captivated millions of players worldwide. In addition to gaming, we explore...
-
Engagement Coordinator
4 weeks ago
Remote, Oregon, United States ReUp Education Full timeWhat we doFounded in 2015, ReUp Education is the only organization that focuses exclusively on helping colleges and universities engage and re-enroll the more than 40 million US residents who have "stopped out" and support them until graduation, through our technology-enabled service. To date, we have re-enrolled nearly 28,500 students and recaptured over...
-
Project Coordinator
2 months ago
Remote, Oregon, United States Life Technologies (Thermo Fisher Scientific) Full timeWork ScheduleOtherEnvironmental ConditionsOffice Job Description SUMMARY OF POSITIONThe Project Coordinator is a critical member of the enterprise Project Management Office and works closely with multiple project managers to ensure the success of internal and client-facing projects related to Corrona's work in auto-immune research and real world evidence for...
-
Industrial Ammonia Refrigeration Specialist 2
2 weeks ago
Remote, Oregon, United States Skillwork Full timeSkillwork is actively searching for a Traveling Industrial Ammonia Refrigeration Specialist 2 to become a part of our dynamic team. This role provides the chance to travel nationwide, collaborate with various organizations, and further develop your expertise.Essential Qualifications:Ammonia Operator 2 or RETA CIRO certification - essential requirementA...
-
Industrial Ammonia Refrigeration Specialist 2
2 weeks ago
Remote, Oregon, United States Skillwork Full timeSkillwork is excited to announce an opening for a Traveling Industrial Ammonia Refrigeration Specialist 2. This role provides the chance to travel nationwide, collaborate with various organizations, and further develop your expertise.Key Qualifications:Ammonia Operator 2 or RETA CIRO certification - essential requirementA minimum of 5 years of experience in...
-
Operations Resource Coordinator
1 month ago
Remote, Oregon, United States Fusion Risk Management Full timeThe Role The Operations Resource Coordinator is a member of the Operations Resource Team responsible for supporting the project resourcing lifecycle within Fusion. This role focuses on improving support, quality and efficiency in Resource Management, and administration of related tools and processes in support of Professional Services. Key skills include...
-
Administrative Contract Coordinator
1 week ago
Remote, Oregon, United States Lee Richard Technology Full timeJob DescriptionPosition: Administrative Contract Coordinator for Government ContractsLocation: Remote/Hybrid (with occasional office visits if required)Type: Part-Time hours per weekDuration: 6 months, Potential for extension or future full-time opportunities based on performanceOverview:We are seeking a detail-oriented and motivated Administrative Contract...
-
eDiscovery Program Coordinator
2 weeks ago
Remote, Oregon, United States Two Point Consulting Full timeJob OverviewTwo Point Consulting is looking to enhance its eDiscovery and Litigation Support divisions by recruiting for the roles of Associate Project Coordinator and Senior Project Coordinator.Key Qualifications:Expertise in Relativity softwareExperience overseeing the complete EDRM lifecycleStrong client interaction skillsPreferred background in legal...
-
PEGA Developer
3 months ago
Remote, Oregon, United States alphateksol Full timeRole PEGA DeveloperDuration 06+ Months Location Remote (St. Louis Missouri)Description Supports Appeals & Grievances Pega Application DevelopmentRequired Bachelor's degree in Computer Science MIS related field or equivalent experience Pega CSSA certification 3+ years of proven work experience as a Pega developer Advanced knowledge of Pega PRPC 8.x Good...
-
PEGA Developer
3 months ago
Remote, United States alphateksol.com Full timeRole PEGA DeveloperDuration 06+ Months Location Remote (St. Louis Missouri)Description Supports Appeals & Grievances Pega Application DevelopmentRequired Bachelor's degree in Computer Science MIS related field or equivalent experience Pega CSSA certification 3+ years of proven work experience as a Pega developer Advanced knowledge of Pega PRPC...
-
Software Developer
2 months ago
Remote, United States Maximus Full timeGeneral information Job Posting Title Software Developer - Java - Remote Date Tuesday, July 2, 2024 City Remote Country United States Working time Full-time Description & Requirements Maximus is currently seeking a Java Developer to join our team supporting one of our Federal clients. Essential Duties and Responsibilities: - Lead the...