- Elevance Health (Indianapolis, IN)
- **Title: Grievance / Appeals Analyst 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 Analyst I** is an entry level position in the Enterprise Grievance & Appeals Department that… more
- Elevance Health (Richmond, VA)
- **Title: Grievance / Appeals Analyst Lead** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of ... a California PulsePoint location. The ** Grievance / Appeals Analyst Lead** will be responsible for leading and coaching a team of Grievance & Appeals … more
- Elevance Health (Los Angeles, CA)
- **Title: Grievance / Appeals Analyst 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 Analyst I** is an entry level position in the Enterprise Grievance & Appeals Department that… more
- Elevance Health (Norfolk, VA)
- ** Grievance / Appeals Analyst Lead** **Candidates must be located within 50 miles of Atlanta, GA, Miami, FL, Mason, OH, Norfolk, VA, Tampa, FL, or Topeka, KS** The ... ** Grievance / Appeals Analyst Lead** is responsible for leading and coaching a team of Grievance & Appeals Analysts in the Enterprise Grievance & … more
- Elevance Health (Meridian, ID)
- **Title: Grievance & Appeals Coordinator** **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 Coordinator** is responsible for investigating and reviewing customer grievances and appeals … more
- Centene Corporation (Springfield, IL)
- …member and provider complaints, grievances and appeals + Maintain files on individual appeals and grievances + May coordinate the Grievance and Appeals ... High school diploma or equivalent. Associate's degree preferred. 2+ years grievance or appeals , claims or related managed care experience. Strong oral, written,… more
- Elevance Health (Meridian, ID)
- **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 accordance… more
- VNS Health (Manhattan, NY)
- …requirements. Also monitors and audits subcontractors who have delegated responsibility for managing grievance and appeals on behalf of the plan to ensure ... and data collection systems and prepares data reports and analysis of grievance and appeals for program management and committees, as needed. Works under general… more
- VNS Health (Manhattan, NY)
- …criteria. + Enters data and assists with compiling reports and analysis on the grievance and appeals process. For Fair Hearings: + Supports Grievance ... to State Fair Hearings. Attends Fair Hearings in person with the Grievance and Appeals ' RN Specialist and presents arguments in defense of the appeals… more
- VNS Health (Manhattan, NY)
- …criteria. + Enters data and assists with compiling reports and analysis on the grievance and appeals process. + Participates in special projects and performs ... experience in health care, including a minimum of two years in a grievance and appeals or related area such as medical or utilization management required +… more
- Centers Plan for Healthy Living (Staten Island, NY)
- Grievance and Appeals Coordinator 75 Vanderbilt Ave, Staten Island, NY 10304, USA Req #660 Wednesday, October 9, 2024 Centers Plan for Healthy Living's goal is ... for healthy living. JOB SUMMARY: As an integral part of the Grievance and Appeals (G&A) Department, the G&A Coordinator lends their support in processing… more
- Elevance Health (KS)
- ** Grievance and Appeals Program Manager, Senior** **Location:** Kansas. This position will work a hybrid model (remote and office). The ideal candidate will live ... 50 miles of one of our Kansas Elevance Health PulsePoint locations. The ** Grievance and Appeals Program Manager, Senior** will be responsible for managing… more
- Robert Half Accountemps (Long Beach, CA)
- …company policies and regulations. + Provide educational assistance to members regarding the grievance and appeals process. + Ensure record keeping system is ... Description We are seeking an experienced Medical Grievances and Appeals Specialist to join our dynamic team. The successful candidate will be responsible for… 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, October 7, 2024 Centers Plan for Healthy Living's goal is ... the guidance and plans they need for healthy living. JOB SUMMARY: The Grievance & Appeal Clinical Reviewer performs complex medical necessity reviewed on Initial… more
- ManpowerGroup (Rancho Cucamonga, CA)
- **Title: Temporary Coordinator - Grievance and Appeals ** **Location:** **Rancho Cucamonga California 91730 (Hybrid)** **Schedule: Telecommute (once or twice a ... Range $20.00 to $23.98/hr.** We are looking for a "Temporary Coordinator - Grievance and Appeals " to join one of our Fortune 500 clients. This is a **Bilingual… more
- CVS Health (Columbus, OH)
- …staff education **Required Qualifications** Compliance experience Audit Experience Grievance and Appeals Experience **Preferred Qualifications** **Education** ... High School Diploma or GED **Pay Range** The typical pay range for this role is: $19.52 - $36.78 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base… more
- Commonwealth Care Alliance (Boston, MA)
- …to appeal and grievances. **What You'll Be Doing:** - Processing of Grievances & Appeals . - Responsible for the progress of grievance and appeal intervention and ... pharmacy, dental, reporting, and member services. - Supports the Senior Appeals & Grievance Coordinator and A/G Coordinator in day-to-day tasks and assignments.… more
- Health First (Rockledge, FL)
- …Plans (Health Insurance)* **Organization:** **HF Administrative Plan Inc* **Title:** *HFHP Appeals / Grievance Coordinator - Member Appeals Grievances* ... **Location:** *Florida - Brevard County-Rockledge* **Requisition ID:** *075564* more
- Baylor Scott & White Health (Temple, TX)
- **JOB SUMMARY** Hybrid position - Temple, TX The Appeals and Grievance Specialist performs reviews, within operational aspects, of the member and provider ... complaints, appeals and grievance cases for products for all lines of business. Responsibilities include, but are not limited to: timely classification and… more
- CVS Health (Salem, OR)
- …ABMS Recognized Specialty **Preferred Qualifications** Medical Management - Medicare Complaints, Grievance & Appeals experience. * Health Plan Experience Highly ... of this Medical Director role are related to Medicare Appeals . * Direct daily work on part C ...Appeals . * Direct daily work on part C appeals (both provider and member/nonparticipating providers). * Provide direct… more
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