. As an Audit and Appeals Specialist, you will: Facilitate responses to regulatory audits related to billing, coding... of audit and appeals processes, including methods, tools, and regulatory standards affecting claims submission and payment...
The Customer Solution Center (CSC) Audit Readiness Specialist II is responsible for the execution, oversight... , Appeals and Grievances across all lines of business). This position is responsible for the ongoing progression and maintenance...
all Grievances and Appeals response letters to Grievances Specialist on daily basis. (20%) Support UM Committee and Audit activity... all due dates for each file. Inform nurses of a new case received from Grievance and Appeals Specialist.; submit...
, Authorization Technician supports the Utilization Management (UM) Specialist by handling all administrative and technical functions...) ,Healthcare Common Procedure Coding System (HCPCs) codes. Technical Support to UM Specialist: Processing of time sensitive...