• Appeals and Grievances

    Generac Power Systems (Waukesha, WI)
    …technology solutions company, we continue to push new boundaries. **Job Description:** The ** Appeals and Grievances Coordinator ** is a critical team player ... events under general supervision with some guidance from leadership and higher-level Appeals and Grievances Specialists. **Job Responsibilities:** + Perform a… more
    Generac Power Systems (11/06/24)
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  • HFHP Appeals /Grievance Coordinator

    Health First (Rockledge, FL)
    …**Organization:** **HF Administrative Plan Inc* **Title:** *HFHP Appeals /Grievance Coordinator - Member Appeals Grievances * **Location:** *Florida ... - Brevard County-Rockledge* **Requisition ID:** *075564* more
    Health First (11/01/24)
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  • Pharmacy Coordinator ( Appeals )

    Centene Corporation (Tallahassee, FL)
    …offering competitive benefits including a fresh perspective on workplace flexibility. Pharmacy Coordinator - ( Grievances , Appeals , and Prior Authorizations) ... the candidate is hired, based on business need. Job specific responsibilities: + Grievances , Appeals , and Prior Authorizations + Processing Pharmacy Appeals more
    Centene Corporation (10/18/24)
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  • Grievance & Appeals Coordinator

    Elevance Health (Meridian, ID)
    Appeals Coordinator ** is responsible for investigating and reviewing customer grievances and appeals regarding provision of service and benefit coverage ... **Title: Grievance & Appeals Coordinator ** **Location:** This position will...issues. Triages clinical and non-clinical inquiries, grievances and appeals , prepares case files for… more
    Elevance Health (11/02/24)
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  • Grievance and Appeals Coordinator

    Centers Plan for Healthy Living (Staten Island, NY)
    …integral part of the Grievance and Appeals (G&A) Department, the G&A Coordinator lends their support in processing member-related grievances and appeals ... Grievance and Appeals Coordinator 75 Vanderbilt Ave, Staten...RESPONSIBILITIES: + Logs and tracks verbal or written member grievances and appeals . + Conducts relevant research… more
    Centers Plan for Healthy Living (10/11/24)
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  • Grievance & Appeals Coordinator I

    Centene Corporation (Springfield, IL)
    …and authorization appeals from providers and pursue resolution of formal grievances from members. + 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 + Maintain files on… more
    Centene Corporation (11/02/24)
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  • Appeals Coordinator

    Brighton Health Plan Solutions, LLC (New York, NY)
    …Health Plan Solutions (BHPS) is seeking an experienced Appeals Coordinator skilled in investigating and resolving grievances , provider payment disputes ... ancillary claims. + Provide accurate and timely responses to appeals , grievances and all other correspondence. + Communicate effectively with individuals/teams… more
    Brighton Health Plan Solutions, LLC (10/10/24)
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  • Appeals & Grievance Specialist

    Commonwealth Care Alliance (Boston, MA)
    **Why This Role is Important to Us:** Appeals and Grievances Representative supports the Operations Department and the Appeals and Grievances team in a ... well as externally to facilitate timely resolution of all grievances and appeals and ensures compliance with...dental, reporting, and member services. - Supports the Senior Appeals & Grievance Coordinator and A/G … more
    Commonwealth Care Alliance (09/07/24)
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  • Medicare Pharmacy Coordinator

    Medical Mutual of Ohio (OH)
    …new or updated CMS regulations, Coverage Gap Discount, Coverage Determinations and Appeals , Grievances , and Medicare marketing material requirements. . Assists ... new or updated CMS regulations, Coverage Gap Discount, Coverage Determinations and Appeals , Grievances , and Medicare marketing material requirements. . Assists… more
    Medical Mutual of Ohio (09/20/24)
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  • LTSS Service Coordinator - Case Manager

    Elevance Health (Jacksonville, FL)
    …Law Enforcement). + Assists and participates in appeal or fair hearings, member grievances , appeals , and state audits. **Minimum Requirements:** + Requires BA/BS ... $5,000 Sign On Bonus **LTSS Service Coordinator ** _Location:_ This is primarily a field based...Polk, Orange, or Palm Beach county. The **LTSS Service Coordinator ** is responsible for conducting service coordination functions for… more
    Elevance Health (10/26/24)
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  • LTSS Service Coordinator

    Elevance Health (Woodbridge, NJ)
    …Law Enforcement). + Assists and participates in appeal or fair hearings, member grievances , appeals , and state audits. **Minimum Requirements:** + Requires BA/BS ... **LTSS Service Coordinator ** _Location:_ This is a hybrid role. Candidate...Morristown) at least once a week. The **LTSS Service Coordinator ** is responsible for conducting service coordination functions for… more
    Elevance Health (10/11/24)
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  • Cdoc - Program Assistant I (Colorado Springs)

    State of Colorado (Colorado Springs, CO)
    …and submits unemployment claim requests; creates and maintains files for all grievances , State Personnel Board appeals , director's reviews, R6-10, and R5-6 ... notices of R6-10, corrective actions, disciplinary actions, administrative separations, appeals , grievances , 1450-05 reports, termination letters; distribute… more
    State of Colorado (11/01/24)
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  • Human Resources Business Partner- Work Lead

    State of Colorado (Denver, CO)
    …employment laws; progressive discipline; records management; recruitment; responding to grievances , appeals , charges of discrimination; reorganization issues; ... retention; selection and selection appeals ; settlement advice; strategic planning and overall HR guidance...this position, please direct your inquiries to our ADAAA Coordinator , Nancy Schmelzer, at cdhs_###@state.co.us or call ###. ~THE… more
    State of Colorado (10/25/24)
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  • DNR EDO Employee and Labor Relations Specialist II

    State of Colorado (Denver, CO)
    …to employee relations and providing analysis of potential risk (legal liability, appeals , grievances ) to the delegated staff authority for employee relations. ... in mediation and resolution of employee disputes, performance appraisals, grievances , and crafting corrective actions. + Advises employees and supervisors… more
    State of Colorado (11/01/24)
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  • Human Resources Operations Lead (Pueblo)

    State of Colorado (Pueblo, CO)
    …employment laws; progressive discipline; records management; recruitment; responding to grievances , appeals , charges of discrimination; reorganization issues; ... retention; selection and selection appeals ; settlement advice; strategic planning and overall HR guidance...this position, please direct your inquiries to our ADAA Coordinator , Nancy Schmelzer, at cdhs_###@state.co.us or call ###. ~THE… more
    State of Colorado (11/05/24)
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  • Correctional, Youth, Security Supervisor III…

    State of Colorado (Golden, CO)
    …development training (as available) + Resolves informal staff grievances . Provide formal/informal performance feedback. Initiate progressive discipline, in ... for all youth + Responds to and resolves youth grievances + Act as first public contact with agency...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
    State of Colorado (11/02/24)
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