About Judi Health Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including: Capital Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions
Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united
When you join the growing BILH team, youre not just taking a job, you’re making a difference in people’s lives.Reporting to the Manager, Patient Financial Services, the Clinical Analyst plays an important role in a high-profile
POSITION SUMMARY: The RN Appeal Administrator will be responsible for the Pre-denial/ Denial and appeal process in addition to Utilization Review, to validate the patient’s placement to be at the most appropriate level of care based on nationally
Location:Work from home (Pennsylvania) Shift:Days (United States of America) Scheduled Weekly Hours:40 Worker Type:Regular Exemption Status:No Job Summary:Provides support in administration of the Appeals and Grievance process. Serves as a liaison between Members and the Plan with
Location:Work from home (Pennsylvania) Shift:Days (United States of America) Scheduled Weekly Hours:40 Worker Type:Regular Exemption Status:No Job Summary:Provides support in administration of the Appeals and Grievance process. Serves as a liaison between Members and the Plan with
This position is in office in Middleburg Heights, Ohio or Milan, Ohio and is 5 days a week for the first 3 months (training period). Then reverts to hybrid model of 3 days in office and
Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the
About Us: Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to
Description REMOTE - this position will be fully remote after training. Texas residents only * Job purpose The Appeals Specialist is responsible for managing insurance denials by reviewing claims and clinical documentation, posting payments, handling correspondence letters
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective
Job Description The New York City Law Department is seeking applicants for the position of Assistant Corporation Counsel in its Appeals Division. The Appeals Division litigates appeals arising from nearly all of the Law Department’s practice areas and prepares
Benefits Comprehensive Health Coverage – Medical, dental, and vision plans to keep you and your family healthy. Future Security: 401(k) with matching Student Loan Support – Up to $10,000 repayment assistance, because we invest in your
Overview This is a Senior Auditor, Team Lead, with responsibility for supervising a team of Clinical Validation Auditors or other audit team members. Team Leaders ensure that the work of others meets productivity standards, quality guidelines
City/StateVirginia Beach, VA Work ShiftFirst (Days) Overview: Sentara Health Plans is hiring an Integrated Nurse Case Manager/Registered Nurse (RN) for Inpatient and Outpatient Clinical Appeals- Remote in Virginia! Status: Full-time, permanent position (40 hours) Standard working hours:
About Us: Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to
Position Summary: The Appeals & Grievances Clinical Specialist is responsible for receiving, investigating and responding verbally and in writing to member and provider clinical appeals and grievances. Duties and Responsibilities: Ensures that appeals and grievances are properly classified (e.g.
In this role, you’ll leverage your expertise in claims adjudication, contract interpretation, and risk management to guide clients, overcome obstacles, and ensure fair, compliant decisions. You’ll collaborate with internal teams and the Law Division, communicate clearly
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves
Administrative Assistant Starting Salary Range: $47,618 - $57,141 Annually You’re an administrative professional looking to use your experience to do meaningful work. GGRC is committed to assisting people with intellectual and developmental disabilities lead lives of