- Molina Healthcare (Omaha, NE)
- …+ 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
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los ... required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve… more
- Commonwealth Care Alliance (Boston, MA)
- 011540 CCA- Appeals & Grievances **Position Summary** Appeals and Grievances Specialist supports the Operations Department and the Appeals and ... as well as externally to facilitate timely resolution of all grievances and appeals and ensures compliance with regulations. Additionally, this position is… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Quality Auditing Specialist II Job Category: Accounting/Finance 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
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Coordinator I (Temporary) Job Category: Customer Service Department: CSC Appeals & Grievances Location: ... safety net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Coordinator I supports the Customer Solution Center … more
- Commonwealth Care Alliance (Boston, MA)
- 011540 CCA- Appeals & Grievances **Position Summary:** Appeals and Grievances Program Advisor monitors and supports the operations and compliance of the ... Appeals and Grievances department through many NCQA...+ Communicate and work collaboratively with AG Representatives, Resolution Specialist and Management to maintain and improve quality of… more
- Robert Half Accountemps (Los Angeles, CA)
- …A Medical IPA Group in Los Angeles is in the immediate need of a Grievance & Appeals Specialist . The Grievance & Appeals Specialist , will be in ... with State/Federal laws, rules, and guidelines. The Grievance & Appeals Specialist will be expected to perform...Basic Medical Terminology * Proven track record in handling Appeals and Medical Grievances * Excellent coordination… more
- LA Care Health Plan (Los Angeles, CA)
- …Center Audit Readiness Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position Type: ... call documentation and categorization, service authorization request and coverage determination , Appeals and Grievances across all lines of business). This… more
- Walworth County (Elkhorn, WI)
- …contact, in home or community Provide information on consumer rights, complaints, grievances and appeals processes and assistance in preparing and filing ... Disability/Elder Benefit Specialist (HHS) Print (https://www.governmentjobs.com/careers/walworthco/jobs/newprint/5021485) Apply Disability/Elder Benefit...complaints, grievances and appeals at the local, state… more
- Department of State - Agency Wide (Washington, DC)
- …and management official related to discipline, adverse actions, performance-based actions, grievances , appeals and other third-party actions. There is no ... and management official related to discipline, adverse actions, performance-based actions, grievances , appeals and other third-party actions. There is no… more
- State of Colorado (CO)
- CDOC - Human Resources Specialist V (Human Resources Manager) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4994350) Apply CDOC - Human ... Resources Specialist V (Human Resources Manager) Salary $7,610.00 - $12,177.00...develop performance plans and sign performance documents; resolve informal grievances ; provide coaching, mentoring, approve leave, manage workloads; +… more
- State of Colorado (Aurora, CO)
- CDOC - Community Programs Specialist III (Re-Entry) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5021171) Apply CDOC - Community Programs ... Specialist III (Re-Entry) Salary $4,906.00 - $7,849.00 Monthly Location Aurora, CO Job Type Full Time Job Number PAR 6412 CPSIII Aurora Department Department of… more
- LA Care Health Plan (Los Angeles, CA)
- … Specialist III Job Category: Administrative, HR, Business Professionals Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position ... working in an Agile or fast-paced environment. Preferred: Experience with Appeals and/or Grievances . Experience measuring learning effectiveness and applying… more
- TEKsystems (Baltimore, MD)
- … background ! Description Job Profile Summary: The Grievance and Appeal Intake Specialist supports the Appeals and Grievance (A&G) function by handling all ... hiring for a FULLY REMOTE Grievance and Appeal Intake Specialist ! This position must sit near or local to...Work involves a review of recorded calls relating to appeals and grievances and prepares written transcripts,… more
- Department of State - Agency Wide (Washington, DC)
- …and management official related to discipline, adverse actions, performance-based actions, grievances , appeals and other third-party actions. There is no ... applicants who respond to this flyer. Responsibilities As a Human Resource Specialist (Employee Relations) at a minimum you will ensure the effective administration… 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 Cambridge Springs Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/5000976) Apply Records Specialist 1 - SCI… more
- Navy Exchange Services (NEX) (Virginia Beach, VA)
- Title: Labor/Employee Relations Specialist I/ II/ III (Non-competitive Progression) Location: United States-Virginia-Virginia Beach Job Number: 250000Q1 Note: This ... Summary: Under the guidance and supervision of a Labor/Employee Relations Specialist or Labor/Employee Relations Manager, responsible for providing technical support… 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
- Tufts Medicine (Boston, MA)
- …a variety of areas including employee discipline/corrective action and employee appeals and the grievance process. 2. Develops and modifies Employee Relations ... 5. Provides union contract administration including the investigation of grievances , drafting grievance responses, MOA preparation. 6. Coordinates and prepares… more
- J&J Family of Companies (Trenton, NJ)
- …eligibility and benefit verification, pre-authorization, billing, coding, claims, and appeals / grievances ); REMs certification; Medicare and Medicaid rules and ... of America **Job Description:** We are searching for the best talent for Area Business Specialist to be in New Jersey territory. This role will cover NJ, DE, MD, and… more