- Fallon Health (Worcester, MA)
- …on Facebook, Twitter and LinkedIn. **Brief summary of purpose:** The Fallon Health (FH) Appeals and Grievance process is an essential function to FH compliance ... & Grievances Coordinator serves to administer the FH Appeals and Grievance process as outlined in...presentation of the member appeal to the FH Medical Director , Center for Medicare/Medicaid Services, contracted reviewer, as well… more
- Humana (Providence, RI)
- …Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....member population, or condition type. May also engage in grievance and appeals reviews. May participate on… more
- Humana (Providence, RI)
- …Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within ... community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement...member population, or condition type. May also engage in grievance and appeals reviews. May participate on… more
- Humana (Providence, RI)
- …Some roles include an overview of coding practices and clinical documentation, dispute/ grievance and appeals processes, and outpatient services and equipment, ... community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement...of care received. May also engage in disputes and grievance and appeals reviews. May participate on… more