- Evolent (Salem, OR)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The ** Coordinator , Appeals and Grievances ** at Evolent is responsible for reviewing ... prior authorization experience. This role is distinct from other coordinator positions in that it is dedicated to case...required. + Minimum of 3 years' experience in an Appeals and Grievances role or comparable administrative… more
- Centene Corporation (Salem, OR)
- …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
- CVS Health (Salem, OR)
- …Prepares information and reports needed to address matters regarding complaints, appeals , and grievances . Carries out policies, procedures, and programs ... state regulations. **What you will do** + Reviews, and processes appeals and grievances filed by patients. + Assists with adherence to regulatory requirements,… more
- Highmark Health (Salem, OR)
- …through paid clams review. + Participate as pharmacy representative in onsite member appeals and grievances sessions. + Serve as a resource for technical ... staff. + Other duties as assigned or requested. **QUALIFICATIONS:** **Minimum** + High school diploma or GED + Experience in pharmacy prescription claims processing/submission/payment. **Preferred** + Associate degree + Pharmacy technician certification… more