- Humana (Raleigh, NC)
- …a team where your expertise truly makes an impact! As a Grievances & Appeals Representative , you'll be a go-to problem solver, turning complex challenges into ... call center or related customer service experience. 2 - 4 years of grievance and/or appeals experience. Previous experience processing medical claims. Additional… more
- Robert Half (Eden Prairie, MN)
- Description Clinical Appeals Representative (Contract - Fully Remote) We're seeking a detail-oriented Clinical Appeals Representative to join our team on ... health insurance operations by managing documentation, coordinating with providers, and ensuring appeals and grievances are processed accurately and on time. This is… more
- CVS Health (Indianapolis, IN)
- …Processes claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system. Educates ... Fluency in English and Spanish is required. Position Summary Customer Service Representative is the face of Aetna and impacts members' service experience by… more
- Transdev (Readville, MA)
- …Research, compile, and prepare data for use in grievance hearings, arbitration proceedings, labor/management initiatives, collective bargaining negotiations, ... Human Resources policies and governmental laws and regulations. Manage the grievance process and provide comprehensive responses to complaints, grievances, and… more
- Point32Health (FL)
- …Point32Health (https://www.point32health.org/) . **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Appeals and ... for the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual… more
- Humana (Richmond, VA)
- …a team where your expertise truly makes an impact! As a Grievances & Appeals Representative , you'll be a go-to problem solver, turning complex challenges into ... customer service experience. + 2 - 4 years of grievance and/or appeals experience. + Previous experience processing medical claims. **Additional Information**… more
- Robert Half Accountemps (Eden Prairie, MN)
- Description Clinical Appeals Representative (Contract - Fully Remote) We're seeking a detail-oriented Clinical Appeals Representative to join our team on ... health insurance operations by managing documentation, coordinating with providers, and ensuring appeals and grievances are processed accurately and on time. This is… more
- Point32Health (Canton, MA)
- …(https://www.point32health.org/) . **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Member Appeals and ... for the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual… more
- Fallon Health (Worcester, MA)
- …us on Facebook, Twitter and LinkedIn. **Brief summary or purpose:** Fallon Health (FH) Appeals and Grievance process is an essential function to FH's compliance ... standards, other applicable regulatory requirements and member expectations. The FH Member Appeals and Grievance Intake Administrator serves to administer the FH… more
- Fallon Health (Worcester, MA)
- …and appeals , which includes,sending the appropriate acknowledgement of the grievance /appeal, educating the member and/or member representative about the ... us on Facebook, Twitter and LinkedIn. **Brief summary of purpose:** Fallon Health (FH) Appeals and Grievance process is an essential function to FH's compliance… more
- MTA (New York, NY)
- Senior Labor Relations Representative Job ID: 12716 Business Unit: MTA Headquarters Location: New York, NY, United States Regular/Temporary: Regular Department: ... Date Posted: Aug 15, 2025 Description JOB TITLE: Senior Labor Relations Representative DEPT/DIV: Labor Relations WORK LOCATION: 420 Lexington Ave FULL/PART-TIME FUL… more
- CVS Health (Woonsocket, RI)
- …Processes claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system. + Educates ... Fluency in English and Spanish is required.** **Position Summary** Customer Service Representative is the face of Aetna and impacts members' service experience by… more
- City of New York (New York, NY)
- …contractual issues that may arise with CFB employees. - Serve as the CFB's grievance representative and administer the contractual grievance process. Serve ... as Hearing Officer for grievances and disciplinary appeals . Represent the agency at hearings before the Office of Labor Relations and arbitration sessions at the… more
- Washington Headquarters Services (Alexandria, VA)
- …on proposals, and researching case law. Serving as the Designated Agency Representative in fact finding, responding to negotiated grievances, and representing the ... guidance to managers and employees in the administration of the OSW/WHS Grievance System; counseling and advising managers and employees regarding their rights and… 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
- Sioux City Community School District (Sioux City, IA)
- …and develop communication for donor stewardship including thank you letters, appeals , newsletters, social media, impact reports, and other communications. + Plan ... perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, education and/or ability required. Reasonable… more
