- AmeriHealth Caritas (Philadelphia, PA)
- …. **This position is hybrid in Philadelphia, PA** **Job Summary** The Appeals & Grievance Case Resolution Specialist is responsible ... for the full life cycle of assigned member and/or provider appeals and grievance cases. Working under general supervision, this role conducts case intake,… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Appeals Specialist I is responsible for the initial analysis of appeals and grievance correspondence, and ... breaching confidentiality of medical information. + Assists Supervisor and Appeals Specialist II and III with unit...with unit projects and other duties related to the appeals , grievance and/or reconsideration processes. Communicates with… more
- Centene Corporation (Sacramento, CA)
- …member and provider material for cultural and linguistic appropriateness. + Monitors grievance and appeals processes for C&L issues. + Proactively identifies ... the state of CA.** **Position Purpose:** The Senior Health Equity Specialist is responsible for maintaining compliance with regulations and contractual obligations… more
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