- Humana (Charleston, WV)
- …Medical Director relies on medical background and reviews health claims and preservice appeals . The Corporate Medical Director works on problems of diverse scope ... and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the appropriateness of… more
- Healthfirst (WV)
- …Triage and assign expedited appeals while helping standardize and optimize how Appeals and Grievances are routed + Manage inventory to ensure regulatory ... meet production, compliance and quality targets to perform all Appeals & Grievances tasks + Build partnerships...several computer applications such as Microsoft Word and Excel, corporate email and virtual filing systems (ie. Macess), and… more
- Highmark Health (Charleston, WV)
- …them to assure ongoing relationships with the corporation maximize their effectiveness. + Grievances and Appeals - Assist in the evaluation and resolution of ... works closely with all divisions and departments within the corporate structure to provide clinical consultation and support with... grievances and appeals of patients, providers, and… more