Appeals Referee Job Description Samples

Results for the star of Appeals Referee

Adult Soccer Referee

Adult Soccer Referee - $25.00 per hour - 8 Positions.Position runs from April to the middle of May (Soccer season, April 3, 2017 - May 15, 2017). Referees are responsible for providing a positive and safe environment for Adult Soccer recreation games. Applicants must possess excellent communication skills, energetic personalities and the ability to work patiently with participants.

This position requires applicants with a working knowledge of the rules of soccer and at least three (3) years of playing experience. Referees must have the ability to interpret and enforce the rules of soccer and must be able to physically keep up with the speed of play.Equal Opportunity Employer.



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Juvenile Court Referee

Announcement Information All applications must clearly indicate how the Minimum Qualifications, if applicable, are met. Provide as much detail as possible under employment history along with the hours worked per week at each job.PURPOSE The purpose of this examination is to establish an eligible list from which to fill present or possible future vacancies in this classification.

For each vacancy, a Department Director/Division Manager has the choice of the applicants in the top group. This list will remain in effect for six months, unless exhausted, superseded by a new eligible list or extended for another six months by the Human Resources Committee.

TRAINING AND EXPERIENCE TEST

The examination will consist of an evaluation of the applicant's responses on the official employment application form that includes supplemental questions regarding the applicant's training and experience. Your responses will be scored and there are no test retakes.

You will be notified of your results by email. The exam content as described above may be modified depending upon the number of applicants or other factors that influence the practicality or usefulness of this selection process. Where minor differences in actual test scores do not reflect meaningful differences in ability, those scores will be statistically grouped resulting in a tie among those applicants.

CLOSING WITHOUT A DATE

This is a continuous examination, and applications will be accepted until such time as there are sufficient applicants to meet the County's current recruitment needs. As such, interested persons should make application promptly.

Applicants will be tested in groups as they apply. Successful applicants, regardless of their testing date, will be ranked on the eligible list based on their final examination scores. The original rank of persons on the eligible list may change as later applicants are tested and added to the list.

Notice of the last date to apply for this examination will be posted in the Human Resources Department and on this posting one week prior to the application deadline. Applications will not be accepted after the posted closing date.

STATE OF MICHIGAN BAR CARD REQUIRED All applicants for this classification must upload a copy of their BAR CARD under the attachment section.

This section is used for BAR CARDS ONLY. Do not upload any other documents such as reference, cover letter, resume, etc. NOTE:

If a job offer is made, OFFICIAL BAR CARD will be required.
Job Summary Under limited direction, presides over various hearings on a daily basis involving matters within Circuit Court Family Division jurisdiction. Insures proceedings are conducted in accordance with applicable law and procedures, due process rights for all parties are preserved and that counsel is available and appointed. Oversees assigned cases and insures compliance with all time deadlines.

Rules on motions, objections and admissions of evidence. Performs fact-finding, draws conclusions of law, researches and drafts opinions and orders and makes recommendations to the judge on the appropriate disposition of all matters. Determines potential risk of harm to and placement of children.

Detains juveniles and assesses community safety and release/bond conditions. Determines the timing of and court expectations for all post judgment reviews. Establishes the amount of and liability for restitution and payment of services and other fees, costs, fines, assessments and costs of care.

Recommends issuance of apprehension orders and bench warrants. Makes findings on the parentage of children and establishes that releases or consents for adoption are made in accordance with applicable law. Researches legal matters, assists in drafting procedures and provides advice and expertise to court staff and the bench.

Remains on-call after working hours and on weekends on a rotating schedule. Utilizes current county-wide and/or department specific software to complete assignments. Minimum Qualifications STATE OF MICHIGAN BAR CARD REQUIRED All applicants for this classification must upload a copy of their BAR CARD under the attachment section.

This section is used for
BAR CARDS ONLY. Do not upload any other documents such as reference, cover letter, resume, etc. NOTE:

If a job offer is made, OFFICIAL BAR CARD will be required.
REQUIRED MINIMUM QUALIFICATIONS 1. Be licensed to practice law in the courts of the State of Michigan; AND 2.

Have had at least five (5) years full-time experience as an attorney practicing law, specializing in child welfare law, and related areas such as child protection, delinquency, status offender, juvenile justice, emancipation of minors, guardianships, and adoption matters. 3. Pass the complete examination, including the employment medical established for the class of Juvenile Court Referee. 4. Successfully complete the six-month probationary period. Special Requirements Must remain in good standing with the State Bar of Michigan.

Salary: $76,603.02 - $99,659.82 Annually Location: Pontiac, MI Job Type: Full Time Job Number: 2017-92 Department: Circuit Court Family Division Closing: Continuous Agency: Oakland County Michigan Address: 2100 Pontiac Lake Road Waterford, Michigan, 48328. Phone: 248-858-0530 Website: http://www.oakgov.com



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Youth Sports Official / Referee Asheville

Under the direction and guidance of the Program Director and consistent with the mission of the YMCA and the policies and guidelines of the YMCA of Western North Carolina, the Sports Official position is responsible for the integral part of monitoring sports activity, making sure all rules are followed and the game is played fairly.

Qualifications: Sports Official/Referee must be able to: * Have an enthusiastic personality and ability to develop harmonious relationships with staff, parents, participants and school faculty.

  • Have a general understanding of sports, rules of the game and have a strong interest working with youth ages 7-12.Physically perform all CPR and First Aid skills.

  • Assist as needed in emergency situations.

  • Move to various locations in and around the entire facility.

  • Bend or stoop and reach to various height levels.

  • Hear noises and distress signals.

  • Demonstrate basic computer skills and competently enter data into the DAXKO computer system.

  • Display strong interpersonal skills including communication (verbal and written), decision making, and conflict resolution. * * * Sports Official/Referee must be a high school graduate, with previous experience in sport of work. He/She must hold and maintain current certifications in the following: * CPR (including adult, infant, child, and two-rescuer) * Community First Aid, including Bloodborne Pathogen Certification

  • Automated External Defibrillation (AED) * Child Abuse Prevention * YMCA Working With Series (preferred) * YMCA Asset Development (preferred) *All required certifications must be obtained within 90 days of employment. * * *

Essential Functions: The Sports Official/Referee must: * Know and understand all YMCA policies and procedures, and ensure that all these procedures are always consistently enforced.

  • Assist as needed in emergency situations and as outlined in emergency procedures.

  • Continuously exhibit honesty, caring, respect, responsibility, reliability, flexibility, maturity, and good decision-making skills.

  • Display a professional, courteous, and tactful demeanor at all times. Always strive to display a positive and enthusiastic attitude.

  • Enforce the rules of the game.

  • Arrive at least 15 minutes prior to your first game scheduled.

  • Complete score sheets at score table. Write in final score, circle winning team, initial games officiated.

  • Facilitate/lead sports discussion with coaches/captains before game.

  • Ensure game starts on time.

  • Take charge. Do not be afraid to blow the whistle.

  • Explain your calls to players and coaches.

  • Ensure safety.

  • Actively engage with coaches. Always explain to the coaches how the game will be called.

  • Ensure goal heights are adjusted according to age division and proper size ball is used.

  • Assist supervisor with set-up/clean-up as needed.

  • Maintain control of game. Keep composure under pressure. Help keep a positive environment. Do not allow coaches or parents to argue with you.

  • Attend all staff meetings and trainings as required.

  • Assist in the identification of active volunteers for the Annual Campaign.

  • Promote and represent the mission and core values of the YMCA of WNC * All other duties assigned by Management. * * *

Effect on End Results: Proper performance of the essential functions of the YMCA Sports Coordinator will result in: * Steady growth in sports programming and participation * YMCA Character Development evidenced in all sports programs.

  • Well maintained, quality YMCA programs driven by input from patrons.

  • Positive and constructive evaluations and feedback (written and oral) from supervisors, members, and program participants.

  • Overall safe, productive, and effective YMCA programs. * * * The YMCA of Western North Carolina is an Equal Opportunity Employer. All qualified applicants will receive consideration without regard to sex, race, color, age, creed, national origin, religion, disability, veteran status, uniformed service member, genetic information, or any other category protected by applicable federal, state, or local laws, regulations or ordinances. No question on our application is intended to secure information to be used for such discrimination. Testing of job-related skills may be required prior to employment.

Level: ExperiencedNot Specified Job Location: USA [NC, Asheville] Position Type: Seasonal Part-time Education Level: Not Specified Salary Range: $9.70 - $18.90 Hourly Travel Percentage: Undisclosed Job Shift: Hours Vary Job Category: Franchise


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Intramural Referee

Job Description: Summary: Job ID = 740.

Assist with the on ice facilitation of the Goggin Ice Center Intramural Sports Program in accordance with the Goggin Ice Center Intramural Rule Books. Assist the Intramural Supervisors and Scorekeepers with pre and post game operations. Provide unbiased and emotionally controlled judgment calls throughout the course of each game.

Officiate intramural ice hockey and broomball games and other supports/events as assigned. Keep score and operate scoreboard as needed. Other duties as assigned.

Minimum Qualifications: Skating experience preferred. Experience in ice related sports and activities is preferred. Knowledge of ice hockey and/or broomball is desired; training is available.

Working Title: Intramural Referee Department: Goggin Ice Center Division: Finance & Business Services Campus: Oxford Posting Date: 11/22/2016 Job Category: Student Position Group: Student Hourly Student Pay Grade Minimum: 8.15 For Inquiries for Posting, Contact: Ben Chuha Posting Inquiries Contact Information (phone, email...): chuhabj@miamioh.edu Application Types Accepted: Student Application Criminal Background Check Required: No



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Basketball Referee

EXOS helps people perform at a high level so they can achieve what matters most to them. Since our founding in 1999, we’ve become a leader in proactive health and performance, trusted by more than 150 clients, including corporations, academic institutions, health systems, sports organizations, the U.S. military, community centers, and residential communities.

With award-winning facilities and spaces, technology, equipment, and services, EXOS connects people to the solutions they need and provides individualized plans based on time-tested fundamentals and research in order to help people take control of their health and performance. We're seeking a Referee to join our team. As a Referee you will: + Officiate at sporting events, games, or competitions, to maintain standards of play and to ensure that game rules are observed.

  • Judge performances in sporting competitions in order to award points, impose scoring penalties, and determine results.

  • Signal participants or other officials to make them aware of infractions or to otherwise regulate play or competition.

  • Inspect sporting equipment and/or examine participants in order to ensure compliance with event and safety regulations.

  • Keep track of event times, including race times and elapsed time during game segments, starting or stopping play when necessary.

  • Start races and competitions. EXOS is proud to be an affirmative action / equal opportunity employer.

    All qualified applicants will receive consideration without regard to race, creed, gender, marital status, sexual orientation, citizenship status, color, religion, national origin, age, disability, veteran status, or any other status protected under local, state, or federal laws. EXOS provides reasonable accommodation to employees and applicants for employment who have disabilities. You may request reasonable accommodation, in writing, by reaching out to our HR department at : Attention : EXOS Human Resources, Accommodations 2629 E.

    Rose Garden Ln. Phoenix, AZ 85050 Learn more here: EEO is the Law EEO is the Law Supplement ID: 2017-8277 External Company URL: www.teamexos.com

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Soccer Referee

Open positions at THINK Together


Referee

  • Soccer Azusa | Baldwin Park | Duarte | El Monte | La Puente * * * * * * THINK Together's mission is to:"Create opportunities for all kids to discover their passion and reach their full potential." Since its inception in 1994, THINK (Teaching, Helping, Inspiring and Nurturing Kids) Together has been committed to improving academic outcomes for children and youth living in under resourced communities. * * *

We are now accepting applications for the following positions * Soccer Referee * * *

Referee The Referee is responsible for the instruction, supervision and officiating of soccer, A knowledge of soccer and previous officiating experience is desired, but not necessarily required. Looking for dependable individuals comfortable presiding over a youth soccer game who are willing and able to make quick judgment calls in accordance with the rules of play. Must be able to hustle, get plays set up quickly, and move up and down the field as necessary. Must learn the rules and enforce them with confidence.

  • Enforces Game rules and regulations.

  • Checks players for proper uniform and equipment.

  • Follows, administers and implements THINK Togethers policies and guidelines. * * *

Requirements: * Experience working with young children and the ability to inspire and motivate.

  • Must clear TB and Fingerprint check. * * *

Hours: * MUST be available at least 3 days a week (5 preferred), Monday

  • Friday (2:30 and 6:00pm).. * * *

Pay: * $11/Hour * * * THINK Together is in search of outstanding individuals from all backgrounds, majors, and career interests. If you think you are ready to shape the lives of students, build relationships with families, provide students with the foundational knowledge, skills and mindset to pursue their dreams and become successful leaders, we invite you to apply.

Posted On: 03/30/2017 Requisition ID: 1061 Job Class: Service Workers


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Flag Football Referee

We are currently looking for athletic and "up beat" individuals to become dedicated members of our staff by providing outstanding officiating for our youth and adult flag football games. Our adult league participates in a 4 on 4 format while the youth league is 5 on 5. Both styles of play tend to be fast paced in nature, therefore any applicant should be prepared to move in a high tempo pace.

  • Prior referee or stat keeper experience is not required.
  • Availability on Sundays between 8:00am and 6:00pm starting in March is a must.
  • Professionalism, punctuality, and a willingness to assert control is what we are looking for.
  • Special consideration will be given for former flag football players.

Requirements

  • 18yrs or older with reliable transportation.
  • Excellent oral communication skills with a passion for working with children and/or adults in a sports setting.
  • Be able to collaborate and consistently perform as a “team player” with other staff members.
  • Willing to participate in on-field and classroom training.

Benefits

Compensation: $13 - $15 per hr based on experience and performance during the assessment training.

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Manager, Denials & Appeals (Rn) – Austin

Manager, Denials & Appeals (RN) – Austin
Joining this team means you'll be surrounded by colleagues who are dedicated to meeting their own high standards, to inspiring their teammates and to making a positive impact on under-insured and uninsured individuals. The group is a fast, agile, customer-focused organization with a commitment to implementing the latest technologies. If these same things get you excited, we hope to hear from you.
Position Purpose: Ensure appropriate processing of member denials and appeals, provider appeals that require clinical review, and/ or State Fair Hearings. Perform duties as the point of contact with the State.

Job Description:

  • Ensure that all denials and appeals are processed in accordance with Federal, State and NCQA time frames and other contractual legal requirements
  • Identify trends within denials and appeals and provide results to internal committees, CMS and the State as required by contract
  • Serve as the point of contact for any issues or questions related to denials and appeals for various external agencies, including state, local and federal governments, local community and the public
  • Integrate federal and state law changes to denials and appeals into company's regulatory system
  • Recommend solutions and ensure issues are corrected and corrective measures are implemented to prevent recurrences
  • May provide training and direction to agencies in developing procedures to comply with denials and appeals requirements

Qualifications:

Education/Experience:
  • Bachelor's degree in Nursing or related clinical field or equivalent experience.
  • 3+ years of utilization management, quality improvement or denials and appeals experience.
  • Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff.
  • Managed care, healthcare law or compliance experience preferred.
Licenses/Certifications:
  • Texas RN (Registered Nurse)
Our client offers options that allow you to do more than just plan for retirement. Their programs allow shared success with employees.
  • 401(k) with company match
  • Employee stock purchase plan
  • Training and Learning Opportunities/Tuition Reimbursement/Educational Assistance
  • On-site fitness center or discount at local fitness centers (most locations)
  • Discounts for select local and national products and services, including cell phones, computers and more
  • Other amenities may be available, but vary by location
Equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

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Appeals Management Analyst

Appeals Management Analyst + Analyze new denials including + Review third party correspondence + Reassign cases that don’t require clinical intervention to Patient Accounting + Refer potential IP-AMS re-bills to the Assistant Director, Clinical Data Management (ie registration errors) + Obtain formal denial letters if possible + Verify Appeal addresses + Assign risk amount + Maintains documentation on denied cases in EPIC based on findings obtained during telephonic discussion with third party payers + Identify denial trends and report them to the Assistant Director, Clinical Data Management for follow-up + Request medical records and follow-up on outstanding requests + Maintain appeals correspondence file + Prepare cases for Appeals Manager upon receipt of medical record + Assist Appeals Manager with mailings + Communicate findings with Patient Accounting and Finance + Refer closed cases to the Assistant Director, Clinical Data Management for further analysis + Provide assistance in the day to day administrative duties for the appeals management program Requirements + Associates Degree required - Bachelors Degree highly desirable + Minimum 2 to 3 years experience with hospital revenue cycle; Inpatient and Outpatient Billing; experience with denials/appeals management highly desirable + Proficient with Microsoft; Eagle; Epic; Allscripts Care Management; Database management + Good customer service skills; attention to detail; flexible; ability to multi-task; Critical thinking ability #LI-JL1 ID: 2017-8739 Hours per Week: 35 Shift: Days External Company Name: Hospital for Special Surgery External Company URL: www.hss.edu


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Grievance & Appeals Coordinator (Medicare)

Title: GRIEVANCE & APPEALS COORDINATOR (MEDICARE) Location:

US-MO-Clayton Job Number: 17204420 Grievance & Appeals Coordinator (Medicare) Our client in the healthcare industry has an immediate opportunity for a full time Grievance & Appeals Coordinator (Medicare) in Clayton, MO. This is a contract to hire opportunity! Our client is now one of the largest providers of Medicaid, Medicare Advantage, and other government-sponsored and commercial programs in the country.

They provide access to affordable healthcare to more than 11 million members across the country.

This is a great opportunity to work with one of the fast growing Fortune 500 companies that has a multi-line healthcare enterprise that provides services to government healthcare programs. If you are selected for this opportunity you will be surrounded by colleagues who are dedicated to meeting their own high standards, to inspiring their teammates and to making a positive impact on under-insured and uninsured individuals.

Our client’s employees are fast, agile, customer-focused multi-taskers with a commitment to implementing the latest technologies. If these same things get you excited, we hope to hear from you. Responsibilities: Position Purpose: Review, investigate and track all Medicare grievances, appeals, and provider claims disputes submitted, and pursue formal resolution for members and providers within required guidelines

  • Screen all incoming grievances, appeals and provider claim dispute to ensure they are in compliance with CMS guidelines and the corporation’s policies

  • Gather, analyze and report verbal and written member and provider complaints, grievances and appeals

  • Prepare response letters for member and provider complaints, grievances and appeals

  • Conduct grievance and appeal investigations and provider claim dispute investigations through internal and external interviews, chart and contract audits, inspection, and interpretations of appropriate CMS guidance and policies

  • Maintain files on individual appeals and grievance cases

  • Manage the corporation’s grievance and appeals database

  • Coordinate with all relevant departments to streamline the appeals and grievance processes

  • Help prepare cases for Medicare Appeals Committee (MAC) review

  • Identify training, process improvement and other ways to maximize team performance and recommend action plans to management Qualifications: * Associate’s degree in health care administration, social work, related field or equivalent experience. * 1 years of social work community relations or grievance and appeals experience, preferably in a managed care environment. To Apply:

    To be considered please immediately apply to this requisition using the link provided. For additional information please contact Shari Dowling at shari.dowling@ctg.com or 541-260-4087 . Kindly forward to any other interested parties—thank you! Qualifications: CTG is the most reliable IT services provider, built on 50 years of meeting our commitments to make technology work for clients and deliver real business value.

    CTG provides industry-specific IT strategy, services, and solutions that address the business needs and staffing challenges of clients in high-growth industries, including major technology companies, large corporations, and government entities located in North America and Western Europe. CTG's greatest asset is its people, and as such we are committed to providing employees programs and processes to support their performance, hone their skills, and advance in their careers. This commitment is reflected by CTG being named a Best Places to Work Company by Modern Healthcare (since 2013) in North America, and a Best Places to Work Company in the United Kingdom (2013), Belgium (since 2007), and Luxembourg (since 2011). CTG will consider for employment all qualified applicants including those with criminal histories in a manner consistent with the requirements of all applicable local, state, and federal laws.

    CTG is an Equal Opportunity/Affirmative Action Employer and strong advocate of workforce diversity. Minority/Female/Sexual Orientation/Gender Identity/Disability/Veteran. Job: Health Payer

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