- LA Care Health Plan (Los Angeles, CA)
- Lead Customer Solution Center Appeals and Grievances Job Category: Administrative, HR, Business Professionals Department: CSC Appeals & Grievances ... to achieve that purpose. Job Summary The Lead of Customer Solution Center Appeals...solutions to handle irate members, and provide optimal customer service for internal and external customers. Must be… more
- 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 ... to support the safety net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will… more
- LA Care Health Plan (Los Angeles, CA)
- …Preferred Required Training Physical Requirements Light Additional Information Department Specifics: Customer Solution Center Appeals and ... matter expertise in functional area to bridge business requirements and IT solutions ; provide technical direction and ensure compliance with best practice … more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Member Navigator II (Location- Metro Los Angeles) Job Category: Customer Service Department: Even MORE Outreach & Service ... net required to achieve that purpose. Job Summary The Customer Solution Center Member Navigator...of experience resolving health care eligibility, access, grievance and appeals issues, preferably in health services, legal services and… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- …healthcare providers with member benefits, eligibility, claims inquiry, claim reconsiderations and appeals . The Customer Service Representatives must be able to ... and communicate effectively with teams. + Transfer misdirected requests and offer solutions to non-routine issues. + Contribute to customer satisfaction and… more
- Brighton Health Plan Solutions, LLC (Melville, NY)
- … needs and concerns; demonstrate empathy and offer solutions . * Confirm customer understanding of the solution and provide additional customer education ... with member benefits, eligibility, claims inquiry, claim reconsiderations and appeals . This job description is not designed to cover...on ways to resolve problems to better serve the customer and/or improve productivity. * Offer solutions … more
- CVS Health (Trenton, NJ)
- …may require coordination of responses from multiple business units. Ensure timely, customer focused response to appeals , complaints and grievance. Identify ... Anchored in our brand - with heart at its center - our purpose sends a personal message that...trends and emerging issues and report and recommend solutions . -Research incoming electronic appeals , complaints and… more
- US Tech Solutions (Orange, CA)
- …High School diploma or equivalent PLUS 2 years of experience as a call center agent or customer /member services representative in health care required; an ... Member Liaison Specialist to join our team. The Member Liaison Specialist ( Customer Service) will provide member service to seniors, persons with disabilities or… more
- State of Colorado (Denver, CO)
- …MINIMUM QUALIFICATIONS: Experience Only: Four (4) years of call center and/or customer service experience. OR Education and ... PEAK Technical Call Center Agent Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4793942) Apply PEAK Technical Call Center Agent Salary… more
- US Tech Solutions (May, OK)
- …inquiries to the pharmacist team as appropriate. **Experience:** 0-3 years in a customer service or call center environment managing 75 calls/day. Six months ... and/or resolve coverage requests. Escalate issues to Coverage Determinations and Appeals Learning Advocates and management team as needed. Must maintain compliance… more
- US Tech Solutions (May, OK)
- …inquiries to the pharmacist team as appropriate. **Experience:** + 0-3 years in a customer service or call center environment managing 75 calls/day. + Six months ... and/or resolve coverage requests. + Escalate issues to Coverage Determinations and Appeals Learning Advocates and management team as needed. + Must maintain… more
- LA Care Health Plan (Los Angeles, CA)
- …and to support the safety net required to achieve that purpose. Job Summary The Customer Solution Center (CSC) Audit Readiness Specialist II is responsible ... Regulatory Compliance Quality Audit Specialist Job Category: Customer Service Department: CSC Appeals &...regulatory functions. Duties Audit readiness: Performs audit procedures for Customer Solution Center departments to… more
- Robert Half Accountemps (Los Angeles, CA)
- …contracts, processing contractual adjustments, knowledge of late charge process * Appeals and denials management *Primary, secondary and tertiary billing/collections ... Hospital Billing, Hospital Inpatient, Hospital Outpatient, Hospital Revenue Cycle, Medical Appeals , Medical Denials Robert Half is the world's first and largest… more
- Robert Half Office Team (Valley Center, CA)
- …and complaints. Requirements + High school diploma or equivalent. + Prior Call Center experience or customer service experience. + Excellent verbal and written ... Description Our esteemed client in Valley Center is actively seeking a competent Call ...with our customers. If a fast-paced, dynamic work environment appeals to you, and you take pride in providing… more
- Community Health Network (Anderson, IN)
- Patient Financial Advocate- Cancer Center Anderson Job Ref 2500024 Category Administrative & General Support Department Oncology Product Intake Center Schedule ... situations, de-escalate, educate, and assist internal/external customers in developing solutions to achieve excellence in resolution while ensuring financial… more
- Zions Bancorporation (Ammon, ID)
- …is an investment in our customers and our business. Your Purpose + Help every customer feel valued by your words and actions + Inspire our customers to tell someone ... about their positive experience + Deliver meaningful solutions for our customers through inbound phone interactions + Seek to add value to each customers' experience… more
- Rush University Medical Center (Chicago, IL)
- **Job Description** Location: Chicago, Illinois Business Unit: Rush Medical Center Hospital: Rush University Medical Center Department: Care Management **Work ... follow-up calls, discharge planning, payer certification, denial avoidance and customer satisfaction. CRC services may be coordinated centrally through department… more
- Whitney Young Health Center (Albany, NY)
- …and regulations; identifies and documents patterns of improper coding and suggests solutions . Educates providers and gives feedback to Director of Revenue Cycle + ... Collaborates with practice managers and Director to ensure health center staff receive adequate training and to resolve any...accordance with contracts, calling payers on open claims, sending appeals on denied claims and following up on requests… more
- US Tech Solutions (RI)
- …etc. 5% **Experience:** Preferred 0-3 years work experience required in a customer service position with high volume call center experience; preferably ... with other internal groups regarding determination status and results (seniors, pharmacists, appeals , etc.). 10% + Identify and elevate clinical inquiries to the… more
- CVS Health (Raleigh, NC)
- …constituents expectations are met or exceeded. + Identifies trends and any emerging customer service issues and works to develop solutions to address potential ... Anchored in our brand - with heart at its center - our purpose sends a personal message that...culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and… more