- Corewell Health (Grand Rapids, MI)
- Job Summary Responsible for the analysis, research and completion of complex member appeal investigations. Effectively administer all steps of the member ... hearing processes for all non-Medicare products to thoroughly investigate appeal requests, leveraging critical thinking skills, gathering relevant information from… more
- Highmark Health (Lansing, MI)
- …reviews inquiries to determine if they meet the definition of a grievance/ appeal ; documents, investigates, refers and coordinates grievances and appeals; initiates a ... case file for each grievance and appeal ; ensures compliance with organizational and regulatory...; ensures compliance with organizational and regulatory requirements for member or provider issues; independently coordinates the resolution with… more