- 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
- Molina Healthcare (Kenmore, WA)
- …claims appeals and grievances using support systems to determine appropriate appeals and grievance outcomes. * Requests and reviews medical records, notes, ... **Essential Job Duties** * Facilitates comprehensive research and resolution of appeals , disputes, grievances, and/or complaints from Molina members, providers, and… 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
- Cedars-Sinai (CA)
- …CSHS employees on company policies and procedures regarding access to care, the grievance and appeals process, the eligibility process, etc. + Remains updated ... **Job Description** The Managed Care Compliance Specialist is responsible for assisting with the implementation...ID** : 11981 **Working Title** : Managed Care Compliance Specialist - Managed Care **Department** : MNS Managed Care… more
- State of Colorado (CO)
- …referrals and consultations, medical reporting, medical co-signature and inmate grievance requirements are completed in accordance with DOC Administrative ... of the department's action. For more information about the appeals process, the official appeal form, and how to...position, please direct your inquiries to our Employee Relations Specialist , Kristen Lange , at doc_###@state.co.us or call ###… more
Related Job Searches:
Appeals,
Appeals Grievance Specialist Remote,
Appeals Specialist,
Grievance,
Grievance Appeals,
Grievance Appeals Specialist Clinical,
Specialist