- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist III Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los ... and to support the safety net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Specialist III will… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los ... to support the safety net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will… more
- CVS Health (Columbus, OH)
- …are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital ... matter and independently coaches others on matters regarding complaints and appeals , ensuring compliance with federal and/or state regulations. Ensures compliance… more
- LA Care Health Plan (Los Angeles, CA)
- …Preferred Required Training Physical Requirements Light Additional Information Department Specifics: Customer Solution Center Appeals and ... matter expertise in functional area to bridge business requirements and IT solutions ; provide technical direction and ensure compliance with best practice … more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Audit Readiness Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, ... net required to achieve that purpose. Job Summary The Customer Solution Center (CSC) Audit...minimum of 5 years of experience in regulatory auditing ( Appeals & Grievances, Call Center , Enrollment) in… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …physicians, hospitals, and other healthcare providers with member benefits, eligibility, and appeals . The Customer Service Representatives must be able to work ... and communicate effectively with teams. + Transfer misdirected requests and offer solutions to non-routine issues. + Contribute to customer satisfaction and… more
- State of Colorado (Lakewood, CO)
- …employees. Our culture has public service focus, and we strive to provide innovative solutions and services to our fellow Coloradans! Careers with a purpose: If you ... the numerous criminal justice computer systems, to include the Colorado Crime Information Center (CCC) and the National Crime Information Center (NCIC) computer… more
- US Tech Solutions (RI)
- …inquiries to the pharmacist team as appropriate. **Experience:** + 0-3 years in a customer service or call center environment managing 75 calls/day. + Six months ... and/or resolve coverage requests. + Escalate issues to Coverage Determinations and Appeals Learning Advocates and management team as needed. + Must maintain… more
- TEKsystems (Columbia, SC)
- …2 years of customer service experience including 1 year claims or appeals processing OR Bachelor's Degree in lieu of work experience. Please add a few ... to resolve inquiries. Reviews and adjudicates claims and/or non-medical appeals . Determines whether to return, deny or pay claims...be a part of team presentations?) Must have previous customer service and call center experience Experience… more
- Whitney Young Health Center (Albany, NY)
- …payers via phone or website, contacting practices, navigating cross-departmentally, writing appeals and facilitating their direction to Athena CBO for submission, ... required by WYH for employment purposes and co-pays when appropriate. + Develops solutions to claim processing and payer adjudication problems. + Learn and keep up… more
- CVS Health (Springfield, IL)
- …every day. **Position Summary** We are currently recruiting top talent for our Center of Excellence Customer Service group. Responsibilities below include, but ... about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our...response to inquiries received. **Required Qualifications** -1 year of Customer service in a call center environment… more
- Iowa Department of Administrative Services (Des Moines, IA)
- …IA Job Type Full-time Job Number 25-03411 Agency 427 Department of Inspections, Appeals & Licensing Opening Date 06/10/2025 Closing Date 6/22/2025 11:59 PM Central ... issues. The Administrative Assistant 2 will be responsible for customer service, explaining our processes to the people we...will also be responsible for promptly and correctly docketing appeals for the Board which includes, but is not… more
- CVS Health (Hartford, CT)
- …constituents expectations are met or exceeded. + Identifies trends and any emerging customer service issues and works to develop solutions to address potential ... about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our...member to ensure you are providing the most complete customer service experience that you can for our members.… more
- US Tech Solutions (RI)
- …etc. 5% **Experience:** Preferred 0-3 years work experience required in a customer service position with high volume call center experience; preferably ... with other internal groups regarding determination status and results (seniors, pharmacists, appeals , etc.). 10% + Identify and elevate clinical inquiries to the… more
- US Tech Solutions (May, OK)
- …email boxes, CAS maintenance, etc. **Experience:** + 0-2 years of experience in customer service or call center environment managing high volume calls. + ... internal groups regarding determination status and results (seniors, pharmacists, appeals , etc). + Identify and elevate clinical inquiries to...+ High School diploma or GED **About US Tech Solutions :** US Tech Solutions is a global… more
- Transdev (Oakland, CA)
- Customer Response No-Show Clerk Transdev in Oakland, California is hiring a Customer Service Representativeto act as a liaison for our customers, providers, and ... client. We are seeking friendly, customer service-oriented people who are dedicated to safety. Transdev...for quarterly audit + Organize and facilitate no-show suspension appeals + Assist callers with questions pertaining to no-shows… more
- CVS Health (Atlanta, GA)
- …ensure constituents expectations are met or exceeded. Identifies trends and any emerging customer service issues and works to develop solutions to address ... are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital… more
- Iowa Department of Administrative Services (State Of Iowa, IA)
- …IA Job Type Full-time Job Number 25-03425 Agency 427 Department of Inspections, Appeals & Licensing Opening Date 06/11/2025 Closing Date 7/1/2025 11:59 PM Central ... achievement with a sense of purpose? The Iowa Department of Inspections, Appeals , and Licensing (DIAL) is seeking a highly motivated, skilled, solution… more
- Iowa Department of Administrative Services (Des Moines, IA)
- …IA Job Type Full-time Job Number 25-03308 Agency 427 Department of Inspections, Appeals & Licensing Opening Date 05/29/2025 Closing Date 6/18/2025 11:59 PM Central ... achievement with a sense of purpose? The Iowa Department of Inspections, Appeals , and Licensing (DIAL) is seeking a highly motivated, skilled, solution… more
- Clark County, NV (Las Vegas, NV)
- …for planning, directing, and reviewing the work of staff that have customer and/or system support responsibilities required to maintain and enhance a large, ... processes, creating functional documentation, capturing detailed requirements for blueprinting, solution design, driving continuous improvement initiatives, and directing staff… more