- CVS Health (Phoenix, AZ)
- …exciting new opportunity within the Grievances team in Scottsdale, AZ. As a Grievance Analyst , you will be responsible for researching, resolving, and ... members have about their coverage and benefits provided through Medicare Part D. You will have the opportunity to...construct a resolution in a timely manner. A successful Analyst is receptive to constructive feedback and flexible in… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeal and Grievance Compliance Advisor Job Category: Administrative, HR, Business Professionals Department: CSC Appeals & Grievances ... Care Services (DHCS), Department of Public Social Services (DPSS), Centers for Medicare and Medicaid Services(CMS), LACC - CalHers, and National Committee for… more
- Motion Recruitment Partners (Durham, NC)
- Appeals Analyst Durham, NC **100% Remote** Contract $15/hr - $19/hr Our client, a nationally recognized and award-winning company in the health insurance vertical, ... a possible contract to hire opening for a Appeals Analyst . They have over 4 million customers and 5,000+...etc. and external sources including pharmaceutical companies, attorneys, providers, Medicare , PBMs, etc. + Coordinate and draft responses to… more
- Kelsey-Seybold Clinic (Pearland, TX)
- …system updates when necessary. **Job Title: Reconciliation Business Analyst ** **Location: Pearland Administrative Office** **Department:** **KS Plan ... of Insurance Regulations including working knowledge of member complaints, grievance , and appeals processing. Demonstrated ability to work independently and… more
- Elevance Health (Denison, TX)
- …member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services ... review tools to conduct extensive research and analyze the grievance and appeal issue(s) and pertinent claims and medical...and regulatory standards and requirements. + As such, the analyst will strictly follow department guidelines and tools to… more
- University of Washington (Seattle, WA)
- …pursuits and natural beauty. **POSITION PURPOSE** The Risk Manager's (Compliance Analyst (ES 10)) primary responsibility is to proactively manage adverse events, ... the primary intermediary with patients and their families if a formal grievance is filed. The position requires highly developed analytical skills, familiarity with… more
- Sharp HealthCare (San Diego, CA)
- …support to the PFS Trainer/Educator, Payment Processing staff, Shared Service Analyst , Uncompensated Care Specialist, and Hospital Auditors. The Manager is ... experience. **Essential Functions** + **QUALITY** Assures compliance with all Medicare and Medi-Cal billing regulations by reviewing bulletins and billing.manuals… more
- CVS Health (Austin, TX)
- …hybrid in Texas** - Lead a team of Medicaid Provider Data Services Analyst responsible for loading and maintaining Medicaid Provider data within Aetna QNXT.- Team ... will also include provider operations analyst and pre-cred support for implementation activities.- Provides assistance and support to other departments, as needed,… more