- 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 ... federal regulations. + Assisting the unit Supervisor in overseeing the appeals and grievances process, ensuring that members and providers receive fair and… 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 ... 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 ... due to the time constraints imposed by CMS on Medicare appeals and grievances . + Collaborates closely with beneficiaries, healthcare providers, and insurance… more
- Elevance Health (Costa Mesa, CA)
- …of clinical information. + The analyst may serve as a liaison between grievances & appeals and /or medical management, legal, and/or service operations and ... **Title: Grievance/ Appeals Analyst I** **Location:** This position...analyzes and processes non-complex pre service and post service grievances and appeals requests from customer types… more
- Point32Health (VA)
- …general direction of the Member Appeals and Grievance Supervisor the Member Appeals and Grievance Analyst is responsible per State and Federal regulations ... responsible for the accurate coordination, efficient administration and resolution of member appeals and member grievances submitted by Point32Health members for… more
- City and County of San Francisco (San Francisco, CA)
- …bargaining agreements. + Key duties include negotiating resolutions to grievances , investigating complaints of serious employee misconduct, and conferring with ... professional human resources experience, similar to 1241 Human Resources Analyst , in one or more of the following areas...to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or… more
- Maryland Department of Transportation (Anne Arundel County, MD)
- Labor Relations Analyst (HR Analyst I) Salary $53,808.00 - $86,322.00 Annually Location Anne Arundel County Job Type Full Time Remote Employment ... + Description + Benefits + Questions Description Labor Relations Analyst (HR Analyst I) Grade 14 Job...limited to: + Preparing and filing documents for employee grievances , disciplinary actions, and unemployment insurance hearings + Attending… more
- Sharp HealthCare (San Diego, CA)
- …billing and collections to all payers through resolution of the accounts. This includes appeals and grievances with all payers and pursuit of private pay ... and special reports + Financial Analysis and ReportingSuccessfully file appeals /PDRs on non-clinical underpaid/denied claims.Explain new legislation impacting underpayments/denials… more
- CareFirst (Baltimore, MD)
- …training and/or other business-related activities. **ESSENTIAL FUNCTIONS:** + Reviews Clinical Appeals and Grievances documentation written by the clinical ... management team. Collaborates with the training team, department business analyst , and the clinical appeals and grievance...team, department business analyst , and the clinical appeals and grievance management team to develop resources for… more
- LA Care Health Plan (Los Angeles, CA)
- …Solution Center Compliance Audit Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position ... call documentation and categorization, service authorization request and coverage determination , Appeals and Grievances across all lines of business). This… more
- State of Colorado (Denver, CO)
- …coordination with DVR finance and CDLE Procurement and Contracts unit; and responds to appeals and grievances at the supervisor level. This position assures that ... in lieu of an available blind operator. Responsible for first level of appeals by licensed blind business operators. Oversee and approve the writing and monitoring… more
- State of Colorado (Lakewood, CO)
- …personnel actions. + Resolve problems, performance issues, disputes, and informal grievances and initiate corrective action or recommend discipline as needed. + ... scheduled background investigations . Minimum Qualification Screening A Human Resources Analyst will only review the work experience/job duties sections of the… more