- CVS Health (Oklahoma City, OK)
- …units. Ensure timely, customer focused response to appeals, complaints and grievance . Identify trends and emerging issues and report and recommend solutions. ... -Research incoming electronic appeals, complaints and grievance to identify if appropriate for unit based upon published business responsibilities. Identify correct… more
- Centene Corporation (Phoenix, AZ)
- …provider regulatory agencies and internal staff. + Correspond with key individuals regarding grievance and appeal decisions. + Act as subject matter expert ... benefits including a fresh perspective on workplace flexibility. **Location: Candidate must live in Arizona. Position is 100% remote.** **Position Purpose:** Analyze… more
- Commonwealth Care Alliance (Boston, MA)
- …pharmacy, dental, reporting, and member services. + Supports the Senior Appeals & Grievance Coordinator and A/G Coordinator in day-to-day tasks and ... Grievances & Appeals: + Responsible for the progress of grievance and appeal intervention and resolution. +...+ 0-2 years **Knowledge, Skills & Abilities (Required)** + Must be a self-starter with a high degree of… more
- Robert Half Accountemps (Los Angeles, CA)
- …guidelines for use by examiners or Participant Services Representatives. * Assist Appeals Coordinator with the preparation of Benefits Committee appeal cases. * ... Los Angeles is in the immediate need of a Grievance & Appeals Specialist. The Grievance &...2 years of experience as a Medical Claims Review Coordinator or in a similar role * Proficient in… more
- Geisinger (Danville, PA)
- …the individual case file and departmental tracking database. + Ensures that all complaint, appeal and grievance time frames are met as dictated by guidelines set ... + Acts as the primary resource regarding the complaint, appeal and grievance processes to all other...*<150 ms Ping Required + *<30ms Jitter Required Computer must be connected to the internet via Ethernet cable;… more
- CVS Health (Sacramento, CA)
- …for all products. Responsible for serving as the point of contact for the appeal if there is an inquiry from leadership, compliance and State regulators. Understand ... team and management. Attention to detail is needed and must be able to maintain compliance turn-around times, with...but not limited to:-Research incoming electronic appeals, complaints and grievance to identify if appropriate for unit based upon… more