- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los ... 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 ... more
- Healthfirst (AL)
- …-QOC experience preferred + Experience in clinical practice with experience in appeals & grievances , claims processing, utilization review or utilization ... more
- LA Care Health Plan (Los Angeles, CA)
- Appeals & Grievances Regulatory Audit Readiness Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los ... more
- LA Care Health Plan (Los Angeles, CA)
- Lead Customer Solution Center Appeals and Grievances Job Category: Administrative, HR, Business Professionals Department: CSC Appeals & Grievances ... more
- Commonwealth Care Alliance (Boston, MA)
- 011540 CCA- Appeals & Grievances **Position Summary:** Appeals and Grievances Program Advisor monitors and supports the operations and compliance of the ... more
- VNS Health (Manhattan, NY)
- OverviewResolves grievances , appeals and external reviews for one of the following VNS Health Plans product lines - Managed Long Term Care (MLTC), Medicare ... 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 ... more
- CDPHP (Albany, NY)
- …values and invites you to be a part of that experience. The Clinical Appeals Specialist is responsible for adhering to a member/provider appeal and grievance ... more
- Elevance Health (Waukesha, WI)
- …& Appeals Coordinator is responsible for investigating and reviewing customer grievances and appeals regarding provision of service and benefit coverage ... more
- BayCare Health System (Clearwater, FL)
- …responsibility and clinical excellence. **Summary:** + Handles and processes customer appeals and grievances in accordance with established guidelines, company ... more
- State of Colorado (Denver, CO)
- …to employee relations and providing analysis of potential risk (legal liability, appeals , grievances ) to the department. Employee relations issues may include, ... more
- Navy Exchange Services (NEX) (Virginia Beach, VA)
- Title: Labor/Employee Relations Specialist I/ II/ III (Non-competitive Progression) Location: United States-Virginia-Virginia Beach Job Number: 250000Q1 Note: This ... more
- Arab Community Center for Economic and Social Serv (Sterling Heights, MI)
- …to access services and rights processes - Assist with resolution of local complaints, grievances , and appeals processes - Survey, track, trend, and report on ... more
- Arab Community Center for Economic and Social Serv (Dearborn, MI)
- …to access services and rights processes + Assist with resolution of local complaints, grievances , and appeals processes + Survey, track, trend, and report on ... more
- J&J Family of Companies (Minneapolis, MN)
- …eligibility and benefit verification, pre-authorization, billing, coding, claims, and appeals / grievances ); practice management; Medicare and Medicaid rules and ... more
- FLACRA (Clifton Springs, NY)
- …closely with Managed Care insurance providers to understand their policies, including grievances and appeals , and assist clients with advocacy as needed. ... more
- City of New York (New York, NY)
- …with beneficiaries to answer questions and clarify Medicare Advantage plan specifics. Appeals and Grievances Support: - Assist beneficiaries in understanding ... more
- City of New York (New York, NY)
- …of Correction ("DOC" or "the Department"); - Investigate serious incidents; - Review grievances from people in custody and staff; - Evaluate the performance of DOC; ... more
- Dignity Health (Bakersfield, CA)
- …manner to the health plan. - Partners as needed with the appeals and grievances functions of the department. **Qualifications** **Minimum Qualifications:** ... more