• Customer Solution Center Appeals

    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 ... purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve member and provider… more
    LA Care Health Plan (08/02/24)
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  • Customer Solution Center Appeals

    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 ... achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Nurse Specialist... Appeals and Grievances (A&G) Nurse Specialist Registered Nurse (RN) II provides direct… more
    LA Care Health Plan (08/17/24)
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  • Pharmacy Benefit Specialist II

    CareOregon (Portland, OR)
    …Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin. Job Title Pharmacy Benefit Specialist II Exemption Status Non-Exempt Department Pharmacy Manager Title ... include customer service, claims processing, prior authorizations, formulary exceptions, appeals , grievances , and project participation. Essential Responsibilities… more
    CareOregon (09/13/24)
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  • Cultural and Linguistic Services Specialist

    LA Care Health Plan (Los Angeles, CA)
    …closely with translation vendors during the high-volume periods. The C&L Specialist II investigates and analyzes member grievances related to C&L Services to ... Cultural and Linguistic Services Specialist II Job Category: Clinical Department:...C&L grievance and complaint process by working closely with Appeals and Grievances (A&G) and language vendors… more
    LA Care Health Plan (08/03/24)
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  • Customer Solution Center Compliance Audit…

    LA Care Health Plan (Los Angeles, CA)
    …Audit Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position Type: Full ... Job Summary The Customer Solution Center (CSC) Audit Readiness Specialist II is responsible for the execution,...and categorization, service authorization request and coverage determination , Appeals and Grievances across all lines of… more
    LA Care Health Plan (08/06/24)
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  • Provider Relations Specialist II

    CareOregon (Portland, OR)
    Job Title Provider Relations Specialist II - Behavorial Health Exemption Status Exempt Department Provider Relations Manager Title Provider Relations Supervisor ... following areas: Provider relations, managed care operations (eg, claims, appeals , grievances , customer service), medical/behavioral health clinic operations,… more
    CareOregon (09/07/24)
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  • Analyst III - Legal Services

    State of Colorado (Colorado Springs, CO)
    …and respond to offender and visitor requests for ADA accommodation, grievances and correspondence by independently researching and evaluating claims and requests ... decision of offender request; + Respond to offender ADA grievances by gathering, investigating and researching pertinent information, interviewing appropriate… more
    State of Colorado (09/05/24)
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