- Generac Power Systems (Waukesha, WI)
- …into an energy technology solutions company, we continue to push new boundaries. The ** Appeals and Grievances Specialist ** is a critical team player who ... under general supervision with some guidance from leadership and higher-level Appeals and Grievances Specialists. **Job Responsibilities:** Case Resolution +… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II Job Category: Administrative, HR, Business Professionals Department: CSC Appeals & ... required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve… more
- Insight Global (Los Angeles, CA)
- Job Description The Customer Solution Center Appeals and Grievances Specialist I will support the Appeals and Grievances team to receive, investigate ... -Primary function of this role is to learn the specialty level appeals and grievances work by resolving less complex cases to ensure positive outcomes for… more
- Sutter Health (Oakland, CA)
- **Organization:** ABSMC-Ashby Campus **Position Overview:** The Grievances & Appeals Specialist supports the patient and family experience through the ... complaints, concerns, and other feedback received by the organizations. Complaints and grievances include, but are not limited to, the care provided by physicians… 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 ... required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Nurse Specialist Registered Nurse (RN) II provides… more
- Sutter Health (Modesto, CA)
- **Organization:** MMC-Memorial Medical Center **Position Overview:** The Grievances & Appeals Specialist supports the patient and family experience through ... complaints, concerns, and other feedback received by the organizations. Complaints and grievances include, but are not limited to, the care provided by physicians… 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 ... purpose. Job Summary The Lead of Customer Solution Center Appeals and Grievances is responsible for assisting...satisfaction. Responsible for the day to day oversight of Appeals and Grievance Specialist by closely monitoring… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** Appeals and Grievances Representative supports the Operations Department and the Appeals and Grievances team in a ... as well as externally to facilitate timely resolution of all grievances and appeals and ensures compliance with regulations. Additionally, this position is… 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 ... each grievance or appeal decision. Develops correspondence communicating the outcome of grievances and appeals to enrollees and/or providers. Assists with… more
- Baylor Scott & White Health (Temple, TX)
- **JOB SUMMARY** The Appeals and Grievance Specialist performs reviews, within operational aspects, of the member and provider complaints, appeals and ... and resolution of cases; review, research and coordination of complaints, grievances , appeals and reconsiderations consistent with statutory and federal… 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 ... Using knowledge of clinical nursing and medical practices, the Clinical Appeals Specialist will review medical necessity requests, render determinations… more
- State of Colorado (Denver, CO)
- …employment laws; progressive discipline; records management; recruitment; responding to grievances , appeals , charges of discrimination; reorganization issues; ... state personnel rules, state and federal employment laws; responding to grievances , equal Employment Opportunity Commission (EEOC) claims, appeals , charges… more
- LA Care Health Plan (Los Angeles, CA)
- …Center Compliance Audit Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position Type: ... call documentation and categorization, service authorization request and coverage determination , Appeals and Grievances across all lines of business). This… more
- Indian Health Service (Shiprock, NM)
- …functions: (a) adverse and disciplinary actions, (b) both administrative and union grievances and appeals , (c) employee benefits including retirement, and (d) ... AZ; 1 for Shiprock, NM. The incumbent serves as a Human Resources Specialist in the field of Employee Relations and Labor Relations which specifically includes… more
- State of Colorado (CO)
- CDOC - Human Resources Specialist V (Human Resources Manager) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4652787) Apply CDOC - Human ... Resources Specialist V (Human Resources Manager) Salary $7,460.00 - $11,938.00...develops performance plans and signs performance documents; resolves informal grievances ; provides coaching, mentoring, approves leave, manages workloads; +… more
- Maryland Department of Transportation (Baltimore City County, MD)
- …and local Employment laws, advising and representing management on employee disciplinary appeals and grievances , as well as experience interacting with ... Labor Relations Specialist (Administrator III) Salary $69,323.00 - $112,044.00 Annually...of experience advising and representing management on employee disciplinary appeals and grievances , as well as experience… more
- Air Education and Training Command (Laughlin AFB, TX)
- …wide variety of human resources management activities and programs including grievances , EEO complaints, appeals , disciplinary actions, adverse actions, ... purpose of this position is to serve as a Human Resources Specialist (Employee Relations) in a developmental capacity, performing assignments designed to further… more
- State of Colorado (CO)
- CDOC - Human Resources Specialist IV (Employee Relations Work Lead) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4650990) Apply CDOC - ... Human Resources Specialist IV (Employee Relations Work Lead) Salary $5,845.00 -...staff on active discrimination/ harassment investigations, grievance panels, ADA, appeals , and other concerns; + Represent the unit to… more
- Naval Air Systems Command (Patuxent River, MD)
- …and employee related matters such as performance, conduct, discipline, adverse actions, grievances , and appeals to maintain a productive climate of ... Summary You will serve as a HUMAN RESOURCES SPECIALIST (LABOR AND EMPLOYEE RELATIONS) in the HUMAN...as conduct in the workplace, disciplinary process, resolution of grievances and appeals , and other actions external… more
- Intermountain Health (Murray, UT)
- …teams in the operational areas of SelectHealth Member Services, Claims, Pharmacy Services, Appeals and Grievances and Sales. It is responsible for the success ... (HBS), Pharmacy Benefits Specialist (PBS) II, AR/Enrollment Specialist II, HBS Claims Processor, Appeals Analyst...II, AR/Enrollment Specialist II, HBS Claims Processor, Appeals Analyst II. + -and- + Demonstrated ability to… more