- Humana (Raleigh, NC)
- …put health first Join a team where your expertise truly makes an impact! As a Grievances & Appeals Representative , you'll be a go-to problem solver, turning ... Use your skills to make an impact Required Qualifications 1+ years of grievances and/or appeals experience. Data entry experience. Intermediate proficiency with… 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.… more
- Transdev (Readville, MA)
- …internal policies and procedures and regulations for accurate resolution of appeals , complaints, and grievances . Understand legal requirements and governmental ... Manage the grievance process and provide comprehensive responses to complaints, grievances , and arbitrations that support the Company's decision and comply with… more
- Humana (Richmond, VA)
- …health first** Join a team where your expertise truly makes an impact! As a Grievances & Appeals Representative , you'll be a go-to problem solver, turning ... to make an impact** **Required Qualifications** + 1+ years of grievances and/or appeals experience. + Data entry experience. + Intermediate proficiency with… more
- Point32Health (MA)
- …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
- Point32Health (Canton, MA)
- …responsible for the accurate coordination, efficient administration and resolution of member appeals and member grievances submitted by Point32Health members for ... (https://www.point32health.org/) . **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Member Appeals and Grievance… more
- Healthfirst (FL)
- …outreach through dismissal and complete verbal outreach attempts** + **Analyze incoming appeals and grievances to determine eligibility for dismissal based on ... to the intricate, multi-step details of the Appointment of Representative (AOR) and Waiver of Liability (WOL) processes to...GED from an accredited institution + Work experience with appeals and grievances or healthcare environment +… 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.… more
- Fallon Health (Worcester, MA)
- …other applicable regulatory requirements and member and provider expectations. The FH Appeals and Grievances Triage Administrator serves to administer the FH ... standards. The Triage Administrator is responsible for triaging and assigning all incoming appeals and grievances addressed to the Member Appeals &… more
- Robert Half Office Team (Minneapolis, MN)
- …you looking for a rewarding remote role in healthcare administration? This Clinical Appeals Representative position offers the opportunity to make a meaningful ... from the comfort of your home. As a Clinical Appeals Representative , you will play a key...key role in managing the intake and processing of grievances and potential quality of care issues on behalf… more
- MTA (New York, NY)
- …and participate in monthly conferences with union representatives to discuss contract grievances and employee discipline appeals ; perform analytical review of ... Senior Labor Relations Representative Job ID: 12716 Business Unit: MTA Headquarters...Aug 15, 2025 Description JOB TITLE: Senior Labor Relations Representative DEPT/DIV: Labor Relations WORK LOCATION: 420 Lexington Ave… more
- Fallon Health (Worcester, MA)
- …of Coverage, departmental policies and procedures, and regulatory standards. The Member Appeals & Grievances Intake Administrator is responsible for triaging and ... assigning all incoming appeals and grievances...acknowledgement of the grievance/appeal, educating the member and/or member representative about the grievance/appeal, gathering all pertinent and relevant… more
- CTG (Boca Raton, FL)
- **Call Center Representative (Bilingual)** **Location:** Boca Raton, FL **Wage:** $17/hr **Duration:** contract to hire with full benefits **Schedule:** Mon-Fri ... to inquiries or provide updates on investigations. + Escalate unresolved customer grievances to appropriate team members or departments. + Process payments and set… more
- New York State Civil Service (Albany, NY)
- …of their legal rights, advises them of complaint filing procedures, assist with appeals / grievances , or refers them to other government or private agencies. * ... Yes Agency Attorney General, Office of the Title Senior Consumer Frauds Representative or Consumer Frauds Representative Trainee (NY HELPS) Occupational Category… 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
- City of New York (New York, NY)
- … and administer the contractual grievance process. Serve as Hearing Officer for grievances and disciplinary appeals . Represent the agency at hearings before the ... play a key role in managing internal labor relations investigations, union grievances , and collective bargaining agreements and engagement with Union Partners, and… more
- UNC Health Care (Morrisville, NC)
- …updates or changes through the Policy Advisory Committee. Review and coordinate appeals and grievances services as applicable. Participate in the coordination ... : Investigation and resolution of teammate relations: Maintain a representative caseload involving variety of complex teammate relations issues, including… 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 ... related to: adverse and disciplinary actions associated with conduct, dispute resolution, grievances , Merit Systems Protection Board (MSPB) appeals , or Office of… 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 (Chaffee County, CO)
- …employee evaluations and plans; conducts performance evaluations, resolves informal grievances ; creates schedules, assigns tasks, inspects work; approves time, ... 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
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