- LA Care Health Plan (Los Angeles, CA)
- Lead Customer Solution Center Appeals and Grievances Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, ... to achieve that purpose. Job Summary The Lead of Customer Solution Center Appeals...solutions to handle irate members, and provide optimal customer service for internal and external customers. Must be… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los ... to support the safety net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Nurse Specialist LVN II Job Category: Clinical Department: CSC Appeals & Grievances Location: Los ... to support the safety net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Nurse Specialist LVN II is… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Nurse Specialist RN II Job Category: Clinical Department: CSC Appeals & Grievances Location: Los ... support the safety net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Nurse Specialist… more
- HCA Healthcare (Nashville, TN)
- …care like family! Jump-start your career as a Coding Operations Education and Appeals Consultant today with HCA Healthcare. The Coding Operations Education and ... Appeals Consultant is responsible for assisting in the efficient...service organization, continuously seeking to understand, meet, and exceed customer expectations and needs. The Education Consultant is responsible… more
- Conduent (Hamilton, NJ)
- …and professionally. **Role Summary** An experienced healthcare (Medicaid & CHIP) call- center based customer service representative to process requests for ... Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating… more
- Vanderbilt University Medical Center (Nashville, TN)
- **Discover Vanderbilt University Medical Center :** Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, ... programs in patient care, education, and research. **Organization:** Interventional Pain Center **Job Summary:** JOB SUMMARY Assists in financial clearance relating… more
- CVS Health (Jacksonville, FL)
- …may require coordination of responses from multiple business units. Ensure timely, customer focused response to complaints/ appeals . Identify trends and emerging ... Anchored in our brand - with heart at its center - our purpose sends a personal message that...culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Compliance Audit Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, ... net required to achieve that purpose. Job Summary The Customer Solution Center (CSC) Audit...minimum of 5 years of experience in regulatory auditing ( Appeals & Grievances, Call Center , Enrollment) in… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Quality Auditor II Job Category: Customer Service Department: Even MORE Quality Location: Los Angeles, CA, US, 90017 Position ... net required to achieve that purpose. Job Summary The Customer Solution Center Quality Auditor...Outreach, Ansafone, Web Inquiries, MRU (Member Relations Unit), and Appeals and Grievance, performance against key performance indicators and… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Member Navigator II (Location- Metro Los Angeles) Job Category: Customer Service Department: Even MORE Outreach & Service ... net required to achieve that purpose. Job Summary The Customer Solution Center Member Navigator...of experience resolving health care eligibility, access, grievance and appeals issues, preferably in health services, legal services and… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- …healthcare providers with member benefits, eligibility, claims inquiry, claim reconsiderations and appeals . The Customer Service Representatives must be able to ... and communicate effectively with teams. + Transfer misdirected requests and offer solutions to non-routine issues. + Contribute to customer satisfaction and… more
- Humana (Frankfort, KY)
- …to provide the best solutions and outcomes working in a best-in-class contact center . As a Call Center Representative 2, you will provide coverage for ... + Associate or Bachelor's Degree + Previous Inbound and / or Outbound call center or related customer service experience + Prior healthcare experience **Work at… more
- Brighton Health Plan Solutions, LLC (Melville, NY)
- … needs and concerns; demonstrate empathy and offer solutions . * Confirm customer understanding of the solution and provide additional customer education ... with member benefits, eligibility, claims inquiry, claim reconsiderations and appeals . This job description is not designed to cover...on ways to resolve problems to better serve the customer and/or improve productivity. * Offer solutions … more
- State of Colorado (Lincoln County, CO)
- …Maintenance Specialist - Hugo Punkin Center Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4543035) Apply Highway Maintenance Specialist ... - Hugo Punkin Center Salary $52,356.00 - $53,000.00 Annually Location Lincoln County,...of Colorado and Colorado Workers for Innovative and New Solutions (COWins). If you have a Colorado Class A… more
- Humana (San Juan, PR)
- …the best solutions and outcomes working in a best-in-class contact center . The Bilingual Inbound Contacts Representative represents the company and our CarePlus ... are fluent in English and Spanish and enjoy providing customer service over the phone, this could be the...as part of Humana's Member Calls Organization! Our Call Center Representatives have a passion for assisting people with… more
- US Tech Solutions (RI)
- …inquiries to the pharmacist team as appropriate. **Experience:** + 0-3 years in a customer service or call center environment managing 75 calls/day. + Six months ... and/or resolve coverage requests. + Escalate issues to Coverage Determinations and Appeals Learning Advocates and management team as needed. + Must maintain… more
- US Tech Solutions (May, OK)
- …inquiries to the pharmacist team as appropriate. **Experience:** 0-3 years in a customer service or call center environment managing 75 calls/day. Six months ... and/or resolve coverage requests. Escalate issues to Coverage Determinations and Appeals Learning Advocates and management team as needed. Must maintain compliance… more
- Surgery Care Affiliates (Fort Worth, TX)
- …dynamic group of physician-driven, specialty care businesses that allows us to customize solutions , no matter the need or challenge: + We connect patients to ... part of Optum and with our new Specialty Management Solutions business. + We have pioneered a physician-led, multi-site...responses and resolution. The PAR will function within the Center 's policies and procedures, support SCA Values, SCA Vision… more
- LA Care Health Plan (Los Angeles, CA)
- …Management, Utilization Management, Risk Adjustment, Products, Customer Solution Center (CSC), reporting and Analytics, Appeals and Grievances and the ... evaluating business operations and processes. Identifies areas where technical solutions would improve business performance. Consults across business operations,… more