- Community Medical Services (South Milwaukee, WI)
- …audits (CARF, OBHL, RHBA, state, DEA, fire, and alarm). Work alongside assigned Clinical Coordinator to assist with grievances , appeals , and complaints from ... clients and oversight agencies of assigned clinics Requirements High School Diploma required At least two (2) years of experience in behavioral health or health services preferred Prior supervisory experience, or experience leading individuals or teams… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Coordinator I (Temporary) Job Category: Customer Service Department: CSC Appeals & Grievances ... required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Coordinator I supports the Customer Solution Center … more
- Centene Corporation (Phoenix, AZ)
- …and authorization appeals from providers and pursue resolution of formal grievances from members. + Gather, analyze and report verbal and written member and ... provider complaints, grievances and appeals + Prepare response letters for member and provider complaints, grievances and appeals + Maintain files on… more
- Centene Corporation (Phoenix, AZ)
- …and authorization appeals from providers and pursue resolution of formal grievances from members. + Gather, analyze and report verbal and written member and ... provider complaints, grievances and appeals + Prepare response letters for member and provider complaints, grievances and appeals + Maintain files on… more
- Commonwealth Care Alliance (Boston, MA)
- 011540 CCA- Appeals & Grievances **Position Summary** Appeals and Grievances Specialist supports the Operations Department and the Appeals and ... well as externally to facilitate timely resolution of all grievances and appeals and ensures compliance with...dental, reporting, and member services. + Supports the Senior Appeals & Grievance Coordinator and A/G … 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. ... 2 years of experience as a Medical Claims Review Coordinator or in a similar role * Proficient in...Basic Medical Terminology * Proven track record in handling Appeals and Medical Grievances * Excellent coordination… more
- Roper St. Francis (Charleston, SC)
- …**Shift: Day shift 8:00am-5:00pm** **Job Summary** **:** The Patient Relations & Legal Coordinator aids in complaints and grievances management as well as legal ... legal field, customer service or healthcare preferred. Prior experience working with grievances and appeals strongly preferred. Knowledge of RSFH organizational… more
- CVS Health (Oklahoma City, OK)
- …every day. **Position Summary** Responsible for intake, investigation and resolution of appeals , complaints and grievances scenarios for all products, which may ... responses from multiple business units. Ensure timely, customer focused response to appeals , complaints and grievance. Identify trends and emerging issues and report… more
- CoreCivic (Leavenworth, KS)
- …a responsibility to better the public good. We are currently seeking a **Grievance Coordinator ** who has a passion for providing the highest quality care in an ... making an impact for the people and communities we serve. The Grievance Coordinator oversees the inmate/resident grievance process and ensures that both informal and… more
- Elevance Health (St. Petersburg, FL)
- …Law Enforcement). + Assists and participates in appeal or fair hearings, member grievances , appeals , and state audits. **Minimum Requirements:** + Requires BA/BS ... **LTSS Service Coordinator ** **Location** _:_ This is primarily a field...law._ **Schedule** _:_ Monday-Friday 8am-5pm EST The **LTSS Service Coordinator ** is responsible for conducting service coordination functions for… more
- Elevance Health (Mason, OH)
- …Law Enforcement). + Assists and participates in appeal or fair hearings, member grievances , appeals , and state audits. **Minimum Requirements:** + Requires BA/BS ... **LTSS Service Coordinator (Case Manager)** **Hiring statewide across Ohio** **Location**...services and supports, and psychosocial needs. The **LTSS Service Coordinator ** is responsible for managing service coordination for a… more
- Elevance Health (Fresno, CA)
- …Law Enforcement). + Assists and participates in appeal or fair hearings, member grievances , appeals , and state audits. **Minimum Requirements:** + Requires BA/BS ... to client needs, and direct, hands-on engagement. The **LTSS Service Coordinator ** is responsible for conducting service coordination functions for a defined… more
- Highmark Health (Oklahoma City, OK)
- …through paid clams review. + Participate as pharmacy representative in onsite member appeals and grievances sessions. + Serve as a resource for technical ... staff. + Other duties as assigned or requested. **QUALIFICATIONS:** **Minimum** + High school diploma or GED + Experience in pharmacy prescription claims processing/submission/payment. **Preferred** + Associate degree + Pharmacy technician certification… more
- State of Colorado (Denver, CO)
- …employment laws; progressive discipline; records management; recruitment; responding to grievances , appeals , charges of discrimination; reorganization issues; ... retention; selection and selection appeals ; settlement advice; strategic planning and overall HR guidance...this position, please direct your inquiries to our ADAAA Coordinator , Nancy Schmelzer, at cdhs_###@state.co.usor call ###. ~THE STATE… more
- State of Colorado (Greeley, CO)
- …+ Ensure that youth grievance policy and procedure are followed. Review of grievances to include investigation, follow up and appropriate action Shift Supervision + ... facility and throughout CYSOs + Functions as the training Coordinator for the facility. Train staff in DYS Policy...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (Pueblo, CO)
- …professional development training (as available). Resolves informal staff grievances . Provide formal/informal performance feedback. Initiate progressive discipline, ... interventions for all youth. Responds to and resolves youth grievances . Act as first public contact with agency when...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (Golden, CO)
- …development training (as available) + Resolves informal staff grievances . Provide formal/informal performance feedback. Initiate progressive discipline, in ... for all youth + Responds to and resolves youth grievances + Act as first public contact with agency...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (Pueblo, CO)
- …and annual audits for education/special education. Responds to any appeals regarding education/special education, special education legal issues, due process ... services, which includes developing and monitoring performance, resolving informal grievances , corrective and disciplinary actions, and ensuring ongoing education… more
- The County of Los Angeles (Los Angeles, CA)
- …personnel in their unit and effectively recommending the adjustment of grievances and disciplinary problems. Other positions are assigned such functions as: ... first level technical and administrative supervision to the complaint or advanced-level appeals unit. Essential Job Functions + Supervises the activities of all… more
- State of Colorado (Denver, CO)
- …years of relevant experience related to handling escalations, complaints, or grievances , data entry experience, basic computer skills, and customer service ... education and/or relevant experience related to handling escalations, complaints, or grievances , data entry experience, basic computer skills, and customer service… more
