- Generac Power Systems (Waukesha, WI)
- ** Appeals & Grievances Specialist I** **Company** Generac Power Systems **Name** Appeals & Grievances Specialist I **Req #** 64663 **Employment ... be challenged and enjoy a fast-paced, high-performance culture. **Job Summary:** The Appeals and Grievances Specialist is a critical team player who is… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Nurse Specialist RN II Job Category: Clinical Department: CSC Appeals & Grievances Location: Los ... required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Nurse Specialist Registered Nurse (RN) II provides… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Training Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: ... required to achieve that purpose. Job Summary The Customer Solutions Center Appeals and Grievances (A&G) Training Specialist II is primarily responsible for… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Quality Auditing Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances ... Job Summary The Customer Solution Center Appeals and Grievances Quality Auditing (QA) Specialist II is responsible for assisting the Appeal and Grievances… more
- Molina Healthcare (Milwaukee, WI)
- …+ Responsible for the comprehensive research and resolution of the appeals , dispute, grievances , and/or complaints from Molina members, providers ... that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance outcomes. +… more
- Robert Half Accountemps (Long Beach, CA)
- Description We are seeking an experienced Medical Grievances and Appeals Specialist to join our dynamic team. The successful candidate will be responsible ... for managing all grievances , appeals and complaint processes related to medical services. You will also play an instrumental role in ensuring consistent… more
- Universal Health Services (Reno, NV)
- …Job Summary: Under the direction of the Manager of Operations, the Appeals Specialist is responsible for ensuring the appropriate review, research, ... processing and responding to written member and provider complaints, appeals , and grievances . This position is required to apply analytical and critical thinking… more
- Elevance Health (Woburn, MA)
- …you will make an impact:** + Conducts investigation and review of customer grievances and appeals involving provision of service and benefit coverage issues. ... medical staff or outside consultant. + Triages clinical and non-clinical inquiries, grievances and appeals , prepares case files for member grievance… more
- Bureau of Reclamation (Boulder City, NV)
- …and guidance for the administration of functions covering adverse actions, grievances and appeals , employee services, communications, employee relations, ... and on conduct-related issues to include adverse/disciplinary actions and grievances / appeals . Investigates, researches, analyzes, identifies, and resolves… more
- State of Colorado (Denver, CO)
- …employment laws; progressive discipline; records management; recruitment; responding to grievances , appeals , charges of discrimination; reorganization issues; ... Labor Management Specialist (Hybrid) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4487540) Apply Labor Management Specialist (Hybrid)… more
- Veterans Affairs, Veterans Health Administration (IN)
- …and Directives. Responding to inquiries and procedures for disciplinary actions, grievances , and appeals concerning timeliness, documentation, and other ... Summary This position serves as a Lead Human Resources Specialist with subject matter expertise in all matters of Employee/Labor Relations within VISN 16. NOTE: This… more
- Drug Enforcement Administration (Arlington County, VA)
- …on a variety of issues relating to disciplinary and adverse actions, performance, grievances , and appeals . Responsibilities As the federal agency whose mission ... variety of issues relating to disciplinary and adverse actions, performance, medical, grievances and appeals . Modifying existing training materials to keep pace… more
- Indian Health Service (Gallup, NM)
- …representatives on the technical aspects of personnel administration during formal hearings, grievances , and appeals . Time In Grade Federal employees in the ... issues. Reviews routine to complex, multi-issue, and multi-party complaints or grievances . Provides advice on the preparation of disciplinary and adverse action,… more
- Naval Facilities Engineering Command (Washington Navy Yard, DC)
- …management in the technical aspects of personnel administration during formal hearings, grievances , and appeals ; and 7) Utilizing performance management software ... Summary You will serve as a HUMAN RESOURCES SPECIALIST (LABOR REL/EMPL REL) in the WORKFORCE DEVELOPMENT DIVISION of NAVAL FAC ENGINEERING CMD WASH. Responsibilities… more
- Naval Sea Systems Command (Pascagoula, MS)
- Summary You will serve as a Paralegal Specialist in the Office of Counsel (Code 130) of SUPSHIP GULF COAST. Responsibilities You will assist the Office of Counsel in ... responsibilities. You will assist the servicing Labor and Employee Relations (LER) Specialist with drafting disciplinary action and preparing responses to union and… more
- Commonwealth of Pennsylvania (PA)
- …Maintains inmate files for compliance with applicable laws and regulations and tracks appeals , misconducts, and grievances in electronic databases and paper case ... Records Specialist 1 - SCI Huntingdon Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/4473693) Apply Records Specialist 1 - SCI Huntingdon… more
- J&J Family of Companies (Los Angeles, CA)
- …eligibility and benefit verification, pre-authorization, billing, coding, claims, and appeals / grievances ); practice management; Medicare and Medicaid rules and ... Area Business Specialist , Immunology - Los Angeles, CA - Janssen...Family of Companies, is recruiting for an Area Business Specialist , Immunology for the Los Angeles, CA territory. At… more
- Arab Community Center for Economic and Social Serv (Dearborn, MI)
- …to access services and rights processes + Assist with resolution of local complaints, grievances , and appeals processes + Survey, track, trend, and report on ... Intake & Customer Service Specialist Department: Community Health & Research Center Location: Dearborn, MI START YOUR APPLICATION… more
- FLACRA (Clifton Springs, NY)
- …closely with all Managed Care insurance providers and their policies and procedures on grievances and appeals , and assists the client in pursuing advocacy as ... UTILIZATION MANAGEMENT SPECIALIST Finger Lakes Addiction Counseling and Referral Agency...the organization's mission, vision and values, the Utilization Management Specialist is responsible for evaluation of the medical necessity,… more
- Justice, Bureau of Prisons/Federal Prison System (Washington, DC)
- …Some examples of this qualifying experience are: GS-13: Experience investigating grievances submitted as administrative remedy appeals , regarding Women and ... in its evaluation and its impact on female offender and specialist populations (aging offenders, parents or pregnant inmates, transgender offenders, inmates… more