- Humana (Raleigh, NC)
- **Become a part of our caring community and help us put health first** The Grievances & Appeals Representative 4 manages client denials and concerns by ... skillsets and/or partnerships with clinical and other Humana parties. The Grievances & Appeals Representative 4 assumes ownership and leads advanced and… 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