- UCLA Health (Los Angeles, CA)
- Description As the Senior Appeals and Grievances Analyst, you will be responsible for: + Assisting with all operational aspects of appeals and grievances ... federal regulations. + Assisting the unit Supervisor in overseeing the appeals and grievances process, ensuring that members and providers receive fair and… more
- Health First (Rockledge, FL)
- …Plan Inc* **Title:** *HFHP Appeal /Grievance Coordinator - Member Appeals Grievances * **Location:** *Florida - Brevard County-Rockledge* **Requisition ... Success in this position will be based on the individual's ability to effectively research, document, analyze and resolve complaints according to complex and strict rules, while identifying and communicating issues appropriately. *PRIMARY ACCOUNTABILITIES:*… 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 achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Nurse Specialist LVN II is primarily responsible for the overall… more
- 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, CA, US, ... achieve that purpose. Job Summary The Lead of Customer Solution Center Appeals and Grievances is responsible for assisting with the development of a successful… 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 Angeles, ... to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Nurse Specialist Registered Nurse (RN) II provides direct… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Appeals and Grievances Clinical Operations RN Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, ... required to achieve that purpose. Job Summary The Supervisor of Appeals and Grievances Clinical Operations (A&G) RN is responsible for executing the day-to-day… 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 Angeles, ... to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve member and… more
- Generac Power Systems (Waukesha, WI)
- …technology solutions company, we continue to push new boundaries. **Job Summary:** The ** Appeals and Grievances Specialist** is a critical team player who is ... under general supervision with some guidance from leadership and higher-level Appeals and Grievances Specialists. **Job Responsibilities:** Case Resolution +… more
- UCLA Health (Los Angeles, CA)
- Description As the Appeals and Grievances (A&G) Analyst, you will be responsible for assisting with all operational aspects of appeals and grievances , in ... due to the time constraints imposed by CMS on Medicare appeals and grievances . + Collaborates closely with beneficiaries, healthcare providers, and insurance… more
- UCLA Health (Los Angeles, CA)
- Description As the Appeals and Grievances (A&G) Analyst, you will be responsible for assisting with all operational aspects of appeals and grievances , in ... due to the time constraints imposed by CMS on Medicare appeals and grievances . + Collaborates closely with beneficiaries, healthcare providers, and insurance… more
- Apex Health Solutions (Houston, TX)
- Summary: The Appeals and Grievances coordinator position is focused on the processing of customer and provider Medicare and Commercial appeals and ... . Adverse Determination and Appeals Tracking. Coordination of Appeals , Adverse Determinations and Grievances . Corresponds with members, providers… more
- Apex Health Solutions (Houston, TX)
- Summary: The Appeals and Grievances coordinator, Senior position, is focused on the processing of customer and provider Medicare and Commercial appeals and ... staff Adverse Determination and Appeals Tracking Coordination of Appeals , Adverse Determinations and Grievances Corresponds with members, providers… more
- Healthfirst (AZ)
- *This position is Remote + Conduct quality audits of A&G items including grievances , pre-service appeals , and post service appeals utilizing appropriate ... processes and performance to ensure quality. + Review and investigate appeals and grievances requests to ensure all requests are identified, classified, and… more
- 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 who ... events under general supervision with some guidance from leadership and higher-level Appeals and Grievances Specialists. **Job Responsibilities:** + Perform a… more
- Health First (Melbourne, FL)
- …to resolve internal operational issues that may cause increase to member appeals / grievances volumes and drive operational efficiencies. 10. Maintain technical ... Insurance)* **Organization:** **HF Administrative Plan Inc* **Title:** *Manager Complaints, Grievances , and Appeals * **Location:** *Florida - Brevard… more
- Humana (Indianapolis, IN)
- …a part of our caring community and help us put health first** The Grievances & Appeals Representative 3 manages client denials and concerns by conducting ... and/or partnerships with clinical and other Humana parties. The Grievances & Appeals Representative 3 performs advanced administrative/operational/customer… more
- Elevance Health (Walnut Creek, CA)
- …+ **Costa Mesa** + **Palo Alto** + **Walnut Creek** The **Manager II Grievance/ Appeals ** is responsible for management oversight of grievances and appeals ... departmental units to investigate, resolve, and respond to grievances and appeals , manages inventory and production levels, and operational and plan risk,… more
- VNS Health (Manhattan, NY)
- …opportunity to: * Lead with Purpose: Manage day-to-day activities for staff handling grievances and appeals across our Managed Long Term Care (MLTC), Medicare ... our high standards for operational and regulatory compliance in managing grievances and appeals on our behalf. * Data-Driven Decisions: Maintain the integrity of… more
- Commonwealth Care Alliance (Boston, MA)
- 011540 CCA- Appeals & Grievances **Position Summary** Appeals and Grievances Specialist supports the Operations Department and the Appeals and ... as well as externally to facilitate timely resolution of all grievances and appeals and ensures compliance with regulations. Additionally, this position is… more
- Elevance Health (Los Angeles, CA)
- …or deny appeal and forwards to Medical Director for approval. + Ensures that appeals and grievances are resolved timely to meet regulatory timeframes. + ... + Utilizes leadership skills and serves as a subject matter expert for appeals / grievances /quality of care issues and is a resource for clinical and non clinical… more
Related Job Searches:
Appeals,
Appeals Grievances Coordinator,
Appeals Grievances Medical Director,
Appeals Grievances Specialist,
Appeals/grievances RN,
Grievances,
Grievances Appeals Representative,
Manager Appeals Grievances,
Medicare Grievances Appeals Corporate,
Supervisor Appeals Grievances