- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Customer Solution Center Appeals and Grievances Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los ... required to achieve that purpose. Job Summary The Supervisor, Customer Solution Center Appeals...independently. Ability to solve complex issues and identify creative solutions . Computer ease and literacy with Microsoft Office (Word,… 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, ... 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 (ALD) Job Category: Customer Service Department: CSC Appeals & Grievances Location: ... 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 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
- Insight Global (Los Angeles, CA)
- Job Description The Supervisor of the Customer Solution Center Appeals and Grievances is responsible for directly supervising and supporting the team ... -At least 3 years in a healthcare setting in Grievances and Appeals , Compliance, Claims or Call Center . -At least 2 years of leading process, program, or staff… more
- Insight Global (Los Angeles, CA)
- Job Description The Customer Solution Center Appeals and Grievances Specialist I will support the Appeals and Grievances team to receive, investigate ... (20%) -Supports the identification, investigation and resolve administrative complaints, simple appeals while adhering to Center for Medicare and Medicaid… more
- CVS Health (Columbus, OH)
- …may require coordination of responses from multiple business units. Ensure timely, customer focused response to appeals , complaints and grievance. Identify ... Anchored in our brand - with heart at its center - our purpose sends a personal message that...trends and emerging issues and report and recommend solutions . -Research incoming electronic appeals , complaints and… more
- HCA Healthcare (Nashville, TN)
- …Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a Clinical Appeals Team Lead with Parallon you can be a part of an organization ... our organization. We are looking for an enthusiastic Clinical Appeals Team Lead to help us reach our goals....unresolved or have been escalated by the Shared Service Center (SSC) operations pre-established protocols. This position will be… more
- LA Care Health Plan (Los Angeles, CA)
- …Preferred Required Training Physical Requirements Light Additional Information Department Specifics: Customer Solution Center Appeals and ... matter expertise in functional area to bridge business requirements and IT solutions ; provide technical direction and ensure compliance with best practice … 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
- State of Colorado (Pueblo, CO)
- …promotes voluntary compliance with all tax laws through education, assistance and customer service. The Service Center serves about 200,000 customers each ... and assessments. + Promote voluntary compliance with tax laws through researching customer problems, identify solutions and needs, and take corrective actions… more
- State of Colorado (Lakewood, CO)
- Watch Center Analyst I Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4665155) Apply Watch Center Analyst I Salary $47,472.00 - ... public service focus, and we strive to provide innovative solutions and services to our fellow Coloradans! Click here...Safety Communications (OPSC). ABOUT THE WORK UNIT The Watch Center component operates 24/7 and supports CDPS leadership as… 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
- 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
- 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 (Meridian, ID)
- …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
- Rush University Medical Center (Chicago, IL)
- **Job Description** **Location:** Chicago, IL **Hospital:** RUSH University Medical Center **Department:** Care Management **Work Type:** Restricted Part Time (Total ... follow-up calls, discharge planning, payer certification, denial avoidance and customer satisfaction. CRC services may be coordinated centrally through department… more
- Whitney Young Health Center (Watervliet, NY)
- …and regulations; identifies and documents patterns of improper coding and suggests solutions . Educates providers and gives feedback to Director of Revenue Cycle + ... Collaborates with practice managers and Director to ensure health center staff receive adequate training and to resolve any...accordance with contracts, calling payers on open claims, sending appeals on denied claims and following up on requests… more