- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Grievances & Appeals Representative 3 manages client denials and concerns by ... trained skillsets and/or partnerships with clinical and other Humana parties. The Grievances & Appeals Representative 3 performs advanced… more
- Elevance Health (Harrisburg, PA)
- **SCA Appeals Representative I** **_Locations:_** _This is a virtual position. The ideal candidate must live within 50 miles of one of our NGS_ **_OR_** ... for Medicare and Medicaid Services to transform federal health programs. The **SCA Appeals Representative I** position is an entry-level position in the NGS… more
- Point32Health (TX)
- …responsible for the accurate coordination, efficient administration and resolution of member appeals and member grievances submitted by Point32Health members for ... + Must be able to organize, plan and implement the functions of Member Appeals and Grievances , maintain timelines and turnaround times to meet multiple… more
- CVS Health (Raleigh, NC)
- …claim hand-offs, and escalates issues as appropriate through the system for grievances and appeals . + Initiates out-reach/welcome calls to ensure constituents ... expectations are met or exceeded. + Identifies trends and any emerging customer service issues and works to develop solutions to address potential problems and/or plan features of interest as an approach to improve understanding of benefit plans and increase… more
- City of New York (New York, NY)
- …jurisdiction of the Department of Correction" - Investigate serious incidents - Review grievances from people in custody and staff - Evaluate the performance of the ... perform other duties as determined by the General Counsel. Appeals Under the Board's Minimum Standards, whenever DOC decides...requirement applies to you, please discuss with the agency representative at the time of interview. WORK LOCATION: 2… more
- Roper St. Francis (SC)
- …legal field, customer service or healthcare preferred. Prior experience working with grievances and appeals strongly preferred. Knowledge of RSFH organizational ... Summary** **:** The Patient Relations & Legal Coordinator aids in complaints and grievances management as well as legal matters to include coordinating with outside… more
- State of Colorado (Arapahoe County, CO)
- …professional development training (as available). Resolves informal staff grievances . Provide formal/informal performance feedback. Initiate progressive discipline, ... interventions for all youth. Responds to and resolves youth grievances . Act as first public contact with agency when...the official appeal form, signed by you or your representative . This form must be delivered to the State… more
- State of Colorado (Golden, CO)
- …development training (as available) + Resolves informal staff grievances . Provide formal/informal performance feedback. Initiate progressive discipline, in ... for all youth + Responds to and resolves youth grievances + Act as first public contact with agency...the official appeal form, signed by you or your representative . This form must be delivered to the State… more
- State of Colorado (Greeley, CO)
- …This supervision entails assigning and evaluating work, handling informal grievances , initiating corrective and disciplinary actions, and participating in the ... This supervision entails assigning and evaluating work, handling informal grievances , initiating corrective and disciplinary actions, and participating in the… more
- CSEA (Albany, NY)
- …of Appeals , NYS DHR, EEOC, Child Abuse Registry; contract grievances and disciplinary arbitration under various state and local collective bargaining agreements; ... forums, including federal appellate court (Second Circuit, Court of Appeals ); state appellate court in the four departments of...your profile and apply for a job, a HR Representative will review your information and contact you. RETURNING… more
- University of Rochester (Rochester, NY)
- …of claims. Collaborate with appropriate departments to generate a detailed rational for appeals and grievances to the insurance companies. 10% Keeps management ... to obtain maximum revenue collection. Research, correct, and resubmit claims, submit appeals and take timely and routine action to resolve unpaid claims. Resolves… more
- Indy Gov (Indianapolis, IN)
- …Monitors and participates in administrative cases, including resident and employee grievances , EEOC matters, Indiana Fair Housing Commission, HUD, and other issues. ... legal instruments, board minutes, and transcripts. * Serve as the primary representative for all civil rights matters, including reviews, reports, and compliance.… more
- State of Colorado (Limon, CO)
- …and ensuring the completion of annual training; + Resolve conflict and informal grievances at the lowest level possible; + Ensure safe, efficient, compliant and cost ... 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
- State of Colorado (Denver, CO)
- …inmate hours and pay, creates schedule and assigns tasks and resolves informal grievances according to agency policy; reduces inmate idleness and creates real life ... 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
- State of Colorado (CO)
- …include dental holds, special diets and work restrictions; + Respond to offender grievances ; + Participate in the daily dental clinic operations to include tool ... 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
- State of Colorado (Denver, CO)
- …disciplinary actions, signing performance plans and appraisals, and resolving Informal grievances . This position is responsible for starting the hiring process, ... 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
- State of Colorado (Grand County, CO)
- …makes recommendations to hire, promote or transfer; + Assists with informal grievances , provides documentation to support corrective actions when needed; + Oversees ... Procedures, 4 CCR 801, for more information about the appeals process. The State Personnel Board Rules and Personnel...the official appeal form, signed by you or your representative , and received at the following address within 10… more
- State of Colorado (Denver, CO)
- …service provision; developing cooperative agreements with local community agencies; mediate appeals and grievances ; project the long-range needs for the ... submitted by you, using the official appeal form signed by you or your representative . This form must be completed and delivered to the State Personnel Board by… more
- State of Colorado (Limon, CO)
- …and maintaining medical supplies for store rooms and examination rooms; + Coordinate grievances by logging and mailing back responses. Complete flow sheets of all ... 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
- State of Colorado (Golden, CO)
- …requests. Manages employee conflicts and respond to both informal and formal grievances as delegated. Participates in team hiring process. Staff scheduling and ... Procedures, 4 CCR 801, for more information about the appeals process. The State Personnel Board rules and Personnel...the official appeal form, signed by you or your representative , and received at the following address within 10… more
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