8 appeals and grievance analyst jobs found

Unitek Learning Company Description As a leading healthcare education organization, Unitek Learning's family of schools helps thousands of students launch and accelerate their careers every year. As a rapidly growing and highly successful company, Unitek is also a great place to pursue a rewarding and challenging career. We offer a competitive salary, generous benefits, unlimited growth potential, and a collegiate work environment. Job Description We are looking for a Campus Dean, BSN Program to join our team on campus with beautiful Sacramento Unitek College. This position will be responsible for the site supervision, development, planning, coordination, organization, implementation and evaluation of the nursing program activities.  Plans, develops, manages, updates and evaluates all aspects of the program including but not limited to:                                                      RN program budget...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Clinical Appeals Nurse completes research, basic analysis, and evaluation of member and provider disputes regarding adverse and adverse coverage decisions. The Clinical Appeals Nurse utilizes clinical skills and knowledge of all applicable State and Federal rules and regulations that govern the appeal process for Commercial and lines of business in order to formulate a professional response to the appeal request. We are looking for an experienced professional to work remotely from within the greater Baltimore metropolitan area. The incumbent will be expected to come into a CareFirst location periodically for meetings, training and/or other business-related activities. ESSENTIAL FUNCTIONS: Investigates, interprets, and analyzes written appeals and reconsideration requests from multiple sources including applicants, subscribers, attorneys, group administrators, internal stake holders and any other...

Unitek Learning Company Description As a leading healthcare education organization, Unitek Learning's family of schools helps thousands of students launch and accelerate their careers every year. As a rapidly growing and highly successful company, Unitek is also a great place to pursue a rewarding and challenging career. We offer a competitive salary, generous benefits, unlimited growth potential, and a collegiate work environment. Job Description We are looking for a Campus Dean, BSN Program to join our team on campus with beautiful Sacramento Unitek College. This position will be responsible for the site supervision, development, planning, coordination, organization, implementation and evaluation of the nursing program activities.  Plans, develops, manages, updates and evaluates all aspects of the program including but not limited to:                                                      RN program budget...

Unitek Learning Company Description As a leading healthcare education organization, Unitek Learning's family of schools helps thousands of students launch and accelerate their careers every year. As a rapidly growing and highly successful company, Unitek is also a great place to pursue a rewarding and challenging career. We offer a competitive salary, generous benefits, unlimited growth potential, and a collegiate work environment. Job Description We are looking for a Campus Dean, BSN Program to join our team on campus with beautiful Sacramento Unitek College. This position will be responsible for the site supervision, development, planning, coordination, organization, implementation and evaluation of the nursing program activities.  Plans, develops, manages, updates and evaluates all aspects of the program including but not limited to:                                                      RN program budget...

Unitek Learning Company Description As a leading healthcare education organization, Unitek Learning's family of schools helps thousands of students launch and accelerate their careers every year. As a rapidly growing and highly successful company, Unitek is also a great place to pursue a rewarding and challenging career. We offer a competitive salary, generous benefits, unlimited growth potential, and a collegiate work environment. Job Description This position will be responsible for the site supervision, development, planning, coordination, organization, implementation and evaluation of the nursing program activities.  Plans, develops, manages, updates and evaluates all aspects of the program including but not limited to:                                                      PN program budget                                                                                Faculty and staff...

Unitek Learning Company Description As a leading healthcare education organization, Unitek Learning's family of schools helps thousands of students launch and accelerate their careers every year. As a rapidly growing and highly successful company, Unitek is also a great place to pursue a rewarding and challenging career. We offer a competitive salary, generous benefits, unlimited growth potential, and a collegiate work environment. Job Description We are looking for an Assistant Dean, BSN Program to join our Phoenix, Brookline College team. This position will be responsible for the site supervision, development, planning, coordination, organization, implementation and evaluation of the nursing program activities.  Plans, develops, manages, updates and evaluates all aspects of the program including but not limited to:                                                      RN program budget...

Unitek Learning Company Description As a leading healthcare education organization, Unitek Learning's family of schools helps thousands of students launch and accelerate their careers every year. As a rapidly growing and highly successful company, Unitek is also a great place to pursue a rewarding and challenging career. We offer a competitive salary, generous benefits, unlimited growth potential, and a collegiate work environment. Job Description We are looking for an Assistant Dean, for our BSN Program to join our team. This position will be responsible for the site supervision, development, planning, coordination, organization, implementation and evaluation of the nursing program activities.  Pay Range - The annual pay range for this position is $120,000 (minimum) and $135,000 (maximum).* Plans, develops, manages, updates and evaluates all aspects of the program including but not limited to:                                                      RN program budget...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: To support the prevention, reduction of and/or recuperation of losses to CareFirst through the clinical review of medical records and claims, resulting in the savings and/or recovery of funds. Responsible for providing clinical knowledge to the SI team to support both prepayment reviews and/or post-payment investigations. ESSENTIAL FUNCTIONS: Review of medical records and claims. Investigate potential fraud and over-utilization by performing complex medical reviews of claims and medical records. The claims may be in a pre or post payment environment. Provide a detailed but concise analysis to communicate findings about the ability to pay or deny a claim or claim lines using clinical and/or coding, billing, or reimbursement knowledge. Maintain appropriate records and supporting documentation regarding findings in accordance with departmental standards. Process all assigned claims or batch case reviews...