- Molina Healthcare (Omaha, NE)
- …(CMS). **Essential Job Duties** * Facilitates comprehensive research and resolution of appeals , disputes, grievances , and/or complaints from Molina members, ... to ensure that internal and/or regulatory timelines are met. * Researches claims appeals and grievances using support systems to determine appropriate appeals… more
- Molina Healthcare (Doral, FL)
- …with research. * Determines appropriate language for letters and prepares responses to member appeals and grievances . * Elevates appropriate appeals to the ... problem-solving in an efficient and timely manner. * Creates and/or maintains appeals and grievances related statistics and reporting. * Collaborates with… more
- Modivcare (Ridgeland, MS)
- …this opportunity may be the right fit for you! Modivcare is looking for an experienced Grievances & Appeals Specialist to join our team! This position is ... risk for service failure. This role + Handles high-risk member complaints and grievances . + Collects all necessary supporting information to accurately provide a… more
- Molina Healthcare (Madison, WI)
- …Represents Member issues in areas involving member impact and engagement including: Appeals and Grievances , Member Problem Research and Resolution, and the ... needs or problem; informs members of their rights in the complaints and appeals process; and advises/refers as appropriate for investigation and resolution. *… more
- Government Publishing Office (Washington, DC)
- …data. Resolves simple, informal complaints of employees and refers formal grievances and appeals to the appropriate official. Requirements Conditions of ... Employment Qualifications To qualify for the Lead Printing Services Specialist , PG-1654-13, you must meet the following requirements: Individual Occupational… more
- City of New York (New York, NY)
- …of Correction ("DOC" or "the Department"); - Investigate serious incidents; - Review grievances from people in custody and staff; - Evaluate the performance of DOC; ... and change. JOB DESCRIPTION The Board seeks a Standards Specialist ("Monitor") with a passion for justice, fairness, and...the Minimum Standards by visiting jails, taking and resolving complaints from staff and people in custody - Examining… more
- Volunteers of America Los Angeles (Los Angeles, CA)
- …verification and resolution of facts and issues in matters affecting disciplinary actions, grievances , appeals , and complaints , refers complex matters to HR ... HR generalist work with 20+% dedicated time committed to handling employee complaints , grievances , interactive processes, and disciplinary actions. + Familiarity… more
- State of Colorado (Pueblo, CO)
- …services/oxygen and equipment/laboratory services after hours. + Addresses patient complaints / complaints of family and resolves patient grievances at the ... Demonstrates understanding of the role of the Patient Right Specialist and utilizes this person as a resource when...if your application is eliminated. You will find the appeals process, the official appeal form, and how to… more
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Specialist Appeals Grievances