- Compass Health Network (St. Peters, MO)
- The Outreach and Enrollment Specialist is responsible for outreach and education to current health center patients and community residents related to theirhealth ... The Health Insurance Marketplace, MO HealthNet or CHIP.* Assist persons with appeals and hearings related to Marketplace and MO HealthNet coverage issues.* Complete… more
- Compass Health Network (St. Peters, MO)
- The Outreach and Enrollment Specialist is responsible for outreach and education to current health center patients and community residents related to theirhealth ... The Health Insurance Marketplace, MO HealthNet or CHIP.* Assist persons with appeals and hearings related to Marketplace and MO HealthNet coverage issues.* Complete… more
- Molina Healthcare (Milwaukee, WI)
- …+ Responsible for the comprehensive research and resolution of the appeals , dispute, grievances , and/or complaints from Molina members, providers ... that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance outcomes. +… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II (ALD) Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los ... required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Nurse Specialist LVN II Job Category: Clinical Department: CSC Appeals & Grievances Location: Los ... required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Nurse Specialist LVN II is primarily responsible for the… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Quality Auditing Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances ... Job Summary The Customer Solution Center Appeals and Grievances Quality Auditing (QA) Specialist II is responsible for assisting the Appeal and Grievances… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Coordinator I Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, ... safety net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Coordinator I supports the Customer Solution Center … 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 (Denver, CO)
- …employment laws; progressive discipline; records management; recruitment; responding to grievances , appeals , charges of discrimination; reorganization issues; ... Benefits Specialist Team Lead Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4554964) Apply Benefits...retention; selection and selection appeals ; workers compensation; settlement advice; strategic planning and overall… more
- US Marine Corps (Quantico, VA)
- …on disciplinary and adverse action notices, performance-based problem notices, processing grievances and appeals ; dealing with complex and sensitive conduct ... Summary You will serve as a Human Resources Specialist (ER) in the Administrative and Resources Division...draft formal correspondence on disciplinary and adverse actions, and appeals . You will represent the Human Resources Branch in… more
- Defense Threat Reduction Agency (Fort Belvoir, VA)
- …management and employees. Provide expert technical guidance and advice on grievances , appeals , disciplinary actions, adverse actions, employee-management issues, ... develops, and assesses program effectiveness.. Responsibilities As a HUMAN RESOURCES SPECIALIST (EMPLOYEE RELATIONS) at the GS-0201-12/13 some of your typical work… more
- Indian Health Service (Gallup, NM)
- …representatives on the technical aspects of personnel administration during formal hearings, grievances , and appeals . Time In Grade Federal employees in the ... issues. Reviews routine to complex, multi-issue, and multi-party complaints or grievances . Provides advice on the preparation of disciplinary and adverse action,… more
- State of Colorado (Denver, CO)
- ECMC Enforcement Supervisor Compliance Specialist V - Hybrid Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4544395) Apply ECMC Enforcement ... Supervisor Compliance Specialist V - Hybrid Salary $86,916.00 - $112,800.00 Annually Location Denver, CO Job Type Full Time Job Number PHA 00060 6/24 Department… more
- Offices, Boards and Divisions (Washington, DC)
- …simple, informal complaints of employees and referring others, such as formal grievances and appeals , to an appropriate management official; Training and ... American people. The Antitrust Division has an opening for a Supervisory Paralegal Specialist to join its dedicated team and gain invaluable experience working in… more
- J&J Family of Companies (Charleston, SC)
- …eligibility and benefit verification, pre-authorization, billing, coding, claims, and appeals / grievances ); practice management; Medicare and Medicaid rules and ... Area Business Specialist , Immunology - South Carolina - Johnson and...Johnson Innovative Medicine is currently seeking a Area Business Specialist to join our Immunology team in South Carolina… more
- J&J Family of Companies (Phoenix, AZ)
- …eligibility and benefit verification, pre-authorization, billing, coding, claims, and appeals / grievances ); practice management; Medicare and Medicaid rules and ... Executive Area Business Specialist - Phoenix, AZ - Johnson and Johnson...Johnson & Johnson is recruiting for Executive Area Business Specialist for Johnson and Johnson Innovative Medicine territory of… more
- J&J Family of Companies (San Antonio, TX)
- …eligibility and benefit verification, pre-authorization, billing, coding, claims, and appeals / grievances ); practice management; Medicare and Medicaid rules and ... Executive Area Business Specialist , Immunology -San Antonio TX -Johnson & Johnson...Johnson & Johnson is recruiting for Executive Area Business Specialist for Immunology located in San Antonio TX. Territory… more
- CareOregon (Portland, OR)
- …following areas: Provider relations, managed care operations (eg, claims, appeals , grievances , customer service), medical/behavioral health clinic operations, ... Job Title Provider Relations Specialist Lead - Behavorial Health Department 116-Provider Relations...partners. + Perform the functions of a Provider Relations Specialist , as needed. Internal Liaison + Participate in interdepartmental… 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 ... Intake & Customer Service Specialist Department: Community Health & Research Center Location: Dearborn, MI START YOUR APPLICATION… more
- Healthfirst (NY)
- …+ Bachelors degree + Experience in clinical practice with experience in appeals & grievances , claims processing, utilization review or utilization ... of services. The end to end process requires the Specialist to independently: + Research issues + Reference and...a framework that measures productivity and quality for each Specialist against expectations + Prepare cases for Medical Director… more
