- Elevance Health (Indianapolis, IN)
- **Title: Grievance / Appeals Representative I** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 ... miles of one of our PulsePoint locations. The ** Grievance / Appeals Representative I** is responsible for reviewing, analyzing and processing claims in… more
- 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 ... **What You'll Be Doing:** - Processing of Grievances & Appeals . - Responsible for the progress of grievance... Appeals . - Responsible for the progress of grievance and appeal intervention and resolution. - Assure verbal… more
- Centers Plan for Healthy Living (Margate, FL)
- RN - Grievance and Appeals Clinical Reviewer 5297 W Copans Rd, Margate, FL 33063, USA Req #461 Monday, September 9, 2024 Centers Plan for Healthy Living's goal ... the guidance and plans they need for healthy living. JOB SUMMARY: The Grievance & Appeal Clinical Reviewer performs complex medical necessity reviewed on Initial… more
- Humana (Columbus, OH)
- …of our caring community and help us put health first** The Grievances & Appeals Representative 4 manages client denials and concerns by conducting a ... with clinical and other Humana parties. The Grievances & Appeals Representative 4 assumes ownership and leads...18 months.** **Required Qualifications** + Minimum 1 year of Grievance & Appeals and/or relevant customer service… more
- MTA (New York, NY)
- …and participate in monthly conferences with union representatives to discuss contract grievance and employee discipline appeals ; perform analytical review of ... Senior Labor Relations Representative Job ID: 6749 Business Unit: MTA Headquarters...sanctioned by the National Mediation Board for all contract grievance and employee discipline cases. + Provide leadership and… more
- Prime Care Coordination (Webster, NY)
- …at least one of the following areas: call center operations, MLTC, grievance and appeals , and/or authorizations. Physical Requirements/Working Conditions: + Must ... Summary: A Member Services Representative is responsible for providing iCircle members with...service in a call center environment. A Member Services Representative provide accurate and efficient services to ensure that… more
- Veterans Benefits Administration (Detroit, MI)
- Summary The Supervisory Veterans Service Representative (Veterans Service Center Manager) manages the Veterans Service Center (VSC) operations through a staff of ... not a virtual position. Position Description/PD#: Supervisory Veterans Service Representative (VSCM)#37978A Relocation Incentive: Relocation expenses are authorized. Appraised… more
- Veterans Benefits Administration (Boise, ID)
- Summary The Supervisory Veterans Service Representative (AVSCM) manages Veterans Service Center (VSC) division operations through a staff of personnel responsible ... not a virtual position. Position Description/PD#: Supervisory Veterans Service Representative (AVSCM)/05055-A Relocation Expenses: Buyer Value Option (BVO) Recruitment… more
- Montana State University (Bozeman, MT)
- …will perform all customer service duties, coordinate the unit's citation appeals process, and provide administrative support. Performs of customer service functions ... + Maintain accurate databases and various digital and paper records. + Screen citation appeals for recommendations to the appeals board. + Schedule and conduct… more
- Sacramento County (Sacramento, CA)
- …Sacramento County service in the class of Senior Personnel Analyst or Labor Relations Representative . Or: 2. Four years of experience in a human resources or labor ... duties, including a minimum of one year experience in discipline, grievance investigation, arbitration, or labor negotiations (public sector experience is highly… more
- City and County of San Francisco (San Francisco, CA)
- …According to Civil Service Commission Rule 109, the duties specified below are representative of the range of duties assigned to this job code/class and are ... members of the public or as elevated through the Citywide ADA Grievance procedure or other responsive complaints mechanisms. Develop recommendations for barrier… more
- TAD PGS, Inc. (Chicago, IL)
- … grievance and disciplinary matters . + Oversees matters related to the Employee Appeals Board and acts as representative of the Employee Appeals Board. ... arbitrators and department work. Reviews hearing officers' decisions in third-step employee grievance and disciplinary matters . Consults with the Bureau Chief of… more
- State of Colorado (CO)
- …met; + Provide guidance to ERU staff on active discrimination/ harassment investigations, grievance panels, ADA, appeals , and other concerns; + Represent the ... the official appeal form, signed by you or your representative . This form must be delivered to the State...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (Adams County, CO)
- …team meetings in collaboration with CYSO III + Ensure that youth grievance policy and procedure are followed. Review of grievances to include investigation, ... the official appeal form, signed by you or your representative . This form must be delivered to the State...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (CO)
- …the Employee & Labor Relations Manager to resolve complaints in coordinating grievance procedures and fully working through the process with management and/or ... Procedures, 4 CCR 801, for more information about the appeals process. The State Personnel Board Rules and Personnel...the official appeal form, signed by you or your representative , and received at the following address within 10… more
- State of Colorado (CO)
- …referrals and consultations, medical reporting, medical co-signature and inmate grievance requirements are completed in accordance with DOC Administrative ... the official appeal form, signed by you or your representative . This form must be delivered to the State...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (Greeley, CO)
- …team meetings in collaboration with CYSO III + Ensure that youth grievance policy and procedure are followed. Review of grievances to include investigation, ... the official appeal form, signed by you or your representative . This form must be delivered to the State...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- Veterans Benefits Administration (Louisville, KY)
- Summary The Supervisory Veterans Service Representative Assistant Veterans Service Center Manager (AVSCM) shares in the responsibility of managing Veterans Service ... not a virtual position. Position Description/PD#: Supervisory Veterans Service Representative (AVSCM)#37977A Relocation/Recruitment Incentive: Relocation expenses are authorized. Financial… more
- Montana State University (Bozeman, MT)
- …when determining if a CO-OP student should appeal a decision, file a grievance , or pursue retroactive withdrawal; guide students in completing scholastic appeals ... with or without reasonable accommodations. The requirements listed above are representative of the knowledge, skill, and/or ability required. This position has… more
- State of Colorado (Denver, CO)
- …administrative needs and provide administrative updates. + Conduct investigative or grievance respondent support when requested by the executive team. + Review, ... submitted by you, using the official appeal form signed by you or your representative . This form must be completed and delivered to the State Personnel Board by… more