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Click Here to search for Grievances-Appeals in our 2.4M jobs.
Online Resumes with "Grievances Appeals"
Grievance and Appeals Coordinator - 5 Years Experience
PROFESSIONAL SUMMARY Quality-driven grievances and appeals coordinator currently seeking a role that would advance my career path with in the health care industry by utilizing my five years' of experience and knowledge with multi-state grievance and appeal issues, to include executive and regulatory case handling.
Tags for this Online Resume: Benefits, Medical, Quality Assurance, Support, Accounting, Bilingual, Billing, Appeals Specialist, Grievance Coordinator, Grievance and Appeals Specialist, Grievance and Appeals Coordinator
Registered Nurse - 20 Years of Experience - Near 95670
Career Summary: Over 20 years of experience in Acute Care and Health Service programs including Utilization Review, Provider Dispute Resolution, Quality Management, Inpatient and Ambulatory Case Management, and Grievance and Appeals in a managed care environment for both Health Plan and IPA/MSO settings using evidence based nationally recognized criteria such as ACOG, NCCN, MCG, InterQual and Health Plan Medical guidelines ...
Tags for this Online Resume: Compliance, Management, Quality Management, Assessments, Medical, Medicare, registered nurse, healthcare, Managed Care, Utilization Management
Quality Coordinator - 20 Years of Experience - Near 11590
Professional with 15+ years of experience in the healthcare industry. Seeking a challenging opportunity with growth potential within an expanding organization where I can utilize my years of reimbursement, collection and Appeals/Grievances experience with outstanding interpersonal, communication and organizational skills. NORTHWELL HEALTH, CARECONNECT A&G Investigator - Greenvale, NY - January 2017 - present * Facilitates m...
Tags for this Online Resume: INTAKE SUPERVISOR, PATIENT FINANCIAL REPRESENTATIVE, REIMBURSEMENT MANAGER, REIMBURSEMENT SPECIALIST, CUSTOMER SERVICE MANAGER, Analytical Skills, Billing, CMM (Capability Maturity Model), Coding, Communication Skills
Billing/Coding Specialist - 20 Years of Experience - Near 10465
Summary of Qualifications -AAPC Member Certified Professional Coder since 2006. -Certified with ICD-10 Medical Coder Certification 2015 -20+ years of experience as a Medical Biller/Medical Coder -Certificate in Medical Terminology, Medical Claim Coding and knowledgeable of the anatomy -Responsible for overseeing troubleshooting problems while reviewing weekly billing. -Able to handle and prioritize multi-task functions simu...
Tags for this Online Resume: Medical, Benefits, Billing, Coding, Documentation, General Surgery, IDX, Insurance, Management, Medical Records, healthcare
Medical or Health Services Manager - 0 Years of Experience
10 plus years of leadership experience in healthcare and nonprofit institutions. * 10 years of experience in grievances and appeals, patient/member services * 10 years of experience in community outreach and engagement * 3 years of experience in provider relations and credentialing * Leading teams of 30 staff members to cohesively reach organization goals * Worked closely with CEO and CMO to develop and execute business so...
Tags for this Online Resume: Leadership, Medical, Transportation, Cms, Complaints, Documentation, Policies and Procedures, Quality, Quality Assurance, Test
Medical or Health Services Manager
Tags for this Online Resume: Customer Service, Training
Registered Nurse
Tags for this Online Resume: ICD-9, Management, Protocol, Quality, Quality Assurance, Quality Management, Patient Care, Assessments, Benefits, Complaints
Director of Quality and Accreditation
Proven success in performance improvement and accreditation by enhancing operations and increasing overall effectiveness. known for effectively evaluating programs and integrating high quality care and service across all operational departments. Passion for leading healthcare organizations through performance improvements leading to successful accreditation (i.e. NCQA, URAC, AAAHC) HEDIS/CAHPS/STARs processes, and state a...
Ideal Companies: Florida Blue, Humana, United Healthcare, Magellan Health Services
Tags for this Online Resume: Cms, Quality, Quality Assurance, Audit, Complaints, Compliance, Management, Utilization Management, Quality Management, Medicare
