- Centene Corporation (Phoenix, AZ)
- …and authorization appeals from providers and pursue resolution of formal grievances from members. + Gather, analyze and report verbal and written member and ... provider complaints, grievances and appeals + Prepare response letters for member and provider complaints, grievances and appeals + Maintain files on… more
- Centene Corporation (Phoenix, AZ)
- …and authorization appeals from providers and pursue resolution of formal grievances from members. + Gather, analyze and report verbal and written member and ... provider complaints, grievances and appeals + Prepare response letters for member and provider complaints, grievances and appeals + Maintain files on… more
- Centene Corporation (Phoenix, AZ)
- …appeals from providers and members. Resolve all State inquires related to complaints, grievances and appeals . + Review and process member and provider ... grievances and appeals within federal, state and organizational regulations and policies...appeal decisions. + Act as subject matter expert regarding grievances and appeals . + Lead Appeals… more
- CVS Health (Sacramento, CA)
- …quality measures, with respect to letter content and turn-around time for appeals , complaints and grievances handling. + Independently researches and translates ... Summary** Responsible for Oversight of that that investigates and resolution of appeals scenarios for all products, which may contain multiple issues and, may… more
- Geisinger (Danville, PA)
- …Services contracted reviewer. Job Duties + Prepares and facilitates Member appeals , complaints and grievances by communicating directly with Members, ... Job Summary Provides support in administration of the Appeals and Grievance process. Serves as a liaison...the full details of the appeal and complaints and grievances by consulting with, but not limited to, health… more
- Commonwealth Care Alliance (Boston, MA)
- 011540 CCA- Appeals & Grievances **Position Summary** Appeals and Grievances Specialist supports the Operations Department and the Appeals and ... well as externally to facilitate timely resolution of all grievances and appeals and ensures compliance with...dental, reporting, and member services. + Supports the Senior Appeals & Grievance Coordinator and A/G … more
- Robert Half Accountemps (Los Angeles, CA)
- …guidelines for use by examiners or Participant Services Representatives. * Assist Appeals Coordinator with the preparation of Benefits Committee appeal cases. ... 2 years of experience as a Medical Claims Review Coordinator or in a similar role * Proficient in...Basic Medical Terminology * Proven track record in handling Appeals and Medical Grievances * Excellent coordination… more
- Roper St. Francis (Charleston, SC)
- …**Shift: Day shift 8:00am-5:00pm** **Job Summary** **:** The Patient Relations & Legal Coordinator aids in complaints and grievances management as well as legal ... legal field, customer service or healthcare preferred. Prior experience working with grievances and appeals strongly preferred. Knowledge of RSFH organizational… more
- Elevance Health (Omaha, NE)
- …Services, Law Enforcement). + Assists and participates in appeal or fair hearings, member grievances , appeals , and state audits. + Travels to worksite and other ... **LTSS Service Coordinator ** _Location:_ Candidate would need to meet face...is granted as required by law._ The **LTSS Service Coordinator ** is responsible for conducting service coordination functions for… more
- Elevance Health (Mason, OH)
- …Law Enforcement). + Assists and participates in appeal or fair hearings, member grievances , appeals , and state audits. **Minimum Requirements:** + Requires BA/BS ... **LTSS Service Coordinator (Case Manager)** **Hiring statewide across Ohio** **Location**...services and supports, and psychosocial needs. The **LTSS Service Coordinator ** is responsible for managing service coordination for a… more
- Elevance Health (Fresno, CA)
- …Law Enforcement). + Assists and participates in appeal or fair hearings, member grievances , appeals , and state audits. **Minimum Requirements:** + Requires BA/BS ... to client needs, and direct, hands-on engagement. The **LTSS Service Coordinator ** is responsible for conducting service coordination functions for a defined… more
- State of Colorado (Denver, CO)
- …employment laws; progressive discipline; records management; recruitment; responding to grievances , appeals , charges of discrimination; reorganization issues; ... retention; selection and selection appeals ; settlement advice; strategic planning and overall HR guidance...this position, please direct your inquiries to our ADAAA Coordinator , Nancy Schmelzer, at cdhs_###@state.co.usor call ###. ~THE STATE… more
- State of Colorado (Pueblo, CO)
- …professional development training (as available). Resolves informal staff grievances . Provide formal/informal performance feedback. Initiate progressive discipline, ... interventions for all youth. Responds to and resolves youth grievances . Act as first public contact with agency when...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (Golden, CO)
- …development training (as available) + Resolves informal staff grievances . Provide formal/informal performance feedback. Initiate progressive discipline, in ... for all youth + Responds to and resolves youth grievances + Act as first public contact with agency...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (Pueblo, CO)
- …and annual audits for education/special education. Responds to any appeals regarding education/special education, special education legal issues, due process ... services, which includes developing and monitoring performance, resolving informal grievances , corrective and disciplinary actions, and ensuring ongoing education… more
- The County of Los Angeles (Los Angeles, CA)
- …personnel in their unit and effectively recommending the adjustment of grievances and disciplinary problems. Other positions are assigned such functions as: ... first level technical and administrative supervision to the complaint or advanced-level appeals unit. Essential Job Functions + Supervises the activities of all… more
- State of Colorado (Denver, CO)
- …years of relevant experience related to handling escalations, complaints, or grievances , data entry experience, basic computer skills, and customer service ... education and/or relevant experience related to handling escalations, complaints, or grievances , data entry experience, basic computer skills, and customer service… more
- State of Colorado (Pueblo, CO)
- …Director. You will find the appeals process, theofficial appeal form ... and Personnel Director's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, within theRules (https://spb.colorado.gov/board-rules) webpage. Supplemental Information… more
- State of Colorado (Denver, CO)
- …plans, corrective and disciplinary actions, assist resolving informal grievances , staff scheduling, position descriptions, recruitment, retention, interviewing and ... of notice or acknowledgement of the department's action. For more information about the appeals process, the official appeal form, and how to deliver it to the State… more
- State of Colorado (Denver, CO)
- …conflicts, investigates and problem solves internal and external complaints and grievances from staff, youth, family, and other customers. Scheduling of clinic ... of the department's action. For more information about the appeals process, the official appeal form, and how to...this position, please direct your inquiries to our ADAA Coordinator , Nancy Schmelzer, at cdhs_###@state.co.us or call ###. ~THE… more