- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Customer Solution Center Appeals and Grievances Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los ... required to achieve that purpose. Job Summary The Supervisor, Customer Solution Center Appeals...independently. Ability to solve complex issues and identify creative solutions . Computer ease and literacy with Microsoft Office (Word,… more
- LA Care Health Plan (Los Angeles, CA)
- Manager, Customer Solution Center Appeals and Grievances Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los ... support the safety net required to achieve that purpose. Job Summary The Manager, Customer Solution Center Appeals and Grievances is responsible for the… 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 & ... support the safety net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Quality Auditing (QA) Specialist… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances...net required to achieve that purpose. Job Summary The Customer Solutions Center Appeals ... II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017...success of new and current staff. Conducts training for Customer Solution Center A&G team… more
- LA Care Health Plan (Los Angeles, CA)
- …and to support the safety net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Nurse Specialist ... Utilization Management/ Appeals and Grievances Nurse Specialist RN II Job...Nurse Specialist RN II Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017… more
- CVS Health (Fresno, CA)
- …and, may require coordination of responses from multiple business units. Ensure timely, customer focused response to appeals . Identify trends and emerging issues ... Anchored in our brand - with heart at its center - our purpose sends a personal message that...and report and recommend solutions . Independently coaches others on appeals ensuring… more
- CVS Health (Phoenix, AZ)
- …care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just ... transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. Position… more
- TEKsystems (Plano, TX)
- …Payment posting, Collection, Medical collections, Medical, Payment poster, Data entry, Customer service, Medical billing, Call center , medicaid, Collection ... Required: + 2+ years of Insurance follow-up, denials/ appeals experience (Medical A/R) + Hospital/facility collections experience...and other team leaders to confirm ie provide trending solutions * File complaints when appropriate for delays in… more
- CVS Health (Tallahassee, FL)
- …may require coordination of responses from multiple business units. Ensure timely, customer focused response to complaints/ appeals . Identify trends and emerging ... Anchored in our brand - with heart at its center - our purpose sends a personal message that...culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeal and...A minimum of 5 years experience in regulatory auditing ( Appeals & Grievances, Call Center , Enrollment) in a ... exemption requests prior to proceeding with the recruitment process. Job Summary The Customer Solution Center Audit Readiness Specialist II is responsible… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Member Navigator II Job Category: Customer Service Department: Even MORE Outreach & Service Location: Los Angeles, CA, US, 90017 ... net required to achieve that purpose. Job Summary The Customer Solution Center Member Navigator...of experience resolving health care eligibility, access, grievance and appeals issues, preferably in health services, legal services and… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Customer Solution Center Member Relations Navigator Job Category: Customer Service Department: Even MORE Outreach & Service Location: Los ... required to achieve that purpose. Job Summary The Supervisor, Customer Solution Center Member Relations...solutions to handle irate callers, and provide optimal customer service for internal and external customers. Must be… more
- University of Pennsylvania (Philadelphia, PA)
- …and much more. Posted Job Title One Stop Counselor - Student Services Center , Division of Finance Job Profile Title Coordinator B Job Description Summary Reporting ... to the Associate Director of the Student Services One Stop Center , and under general supervision, the One Stop Counselor is responsible for providing a comprehensive… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- …healthcare providers with member benefits, eligibility, claims inquiry, claim reconsiderations and appeals . The Customer Service Representatives must be able to ... and communicate effectively with teams. + Transfer misdirected requests and offer solutions to non-routine issues. + Contribute to customer satisfaction and… more
- Surgery Care Affiliates (Mokena, IL)
- …dynamic group of physician-driven, specialty care businesses that allows us to customize solutions , no matter the need or challenge: + We connect patients to ... part of Optum and with our new Specialty Management Solutions business. + We have pioneered a physician-led, multi-site...responses and resolution. The PAR will function within the Center 's policies and procedures, support SCA Values, SCA Vision… more
- Kepro (Harrisburg, PA)
- …The Call Center Support Coordinator will provide telephone and/or e-mail-based customer support to both internal and external customers. *Position is remote, but ... and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact. Lead the... in the public sector. Acentra seeks a Call Center Support Coordinator (Remote) to join our growing team.… more
- Children's Evaluation & Therapy Center (Lanham, MD)
- …insurance companies and clients. They provide outstanding professional and interpersonal customer service by means of email, phone calls and in-person conversations. ... any denials or rejections within timely filing. . Initiate appeals , corrects claim submissions, and submit medical records in...clients remain informed of any outstanding debts and provides solutions to any of the client's relative problems. .… more
- Transdev (San Francisco, CA)
- …have at least three (3) years of experience conducting assessments of client/ customer eligibility for ADA paratransit services. Key Duties: This position's primary ... in-person interview to arrive at a determination. Analysts also participate in any appeals hearing related to a contested determination. The person in this position… more
- LA Care Health Plan (Los Angeles, CA)
- …Management, Utilization Management, Risk Adjustment, Products, Customer Solution Center (CSC), reporting and Analytics, Appeals and Grievances and the ... when appropriate. Must demonstrate ability to work collaboratively and seek solutions proactively applying critical thinking skills in evaluating priorities and … more
- Cleveland Clinic (Beachwood, OH)
- …thorough benefits investigation and processes any necessary prior authorizations and/or appeals for pharmacy claims. + Explains benefit coverage and financial ... of results as needed. + Communicates with patients in a professional and customer -friendly manner in order to schedule the delivery of new and refilled medications… more