- US Tech Solutions, Inc. (Columbia, SC)
- …and related reprocessing actions. Reviews and adjudicates claims and/or non-medical appeals . Determines whether to return, deny or pay claims following ... guidelines. . *40% Examines and processes claims and/or non-medical appeals according to business/contract regulations, internal standards and examining guidelines.… more
- US Tech Solutions, Inc. (Atlanta, GA)
- …sorting, email boxes, CAS maintenance, etc. Experience: 1-3 years of experience in customer service or call center environment managing high volume calls. 6 ... other internal groups regarding determination status and results (seniors, pharmacists, appeals , etc). Identify and elevate clinical inquiries to the pharmacist team… more
- Beacon Hill (Robinson Township, PA)
- …Specialists to join their team! Searching for individuals with prior healthcare-based customer service experience. This company offers a variety of schedules to ... Identify any payer coverage restrictions- Document prior authorization and appeals protocols- Communicate regularly with internal and external partiesRequirements:-… more
- Northeast Georgia Health System, Inc (Oakwood, GA)
- …the highest-level customer service to patients and other CBO or center staff by following through on phone calls, site questions/concerns and account inquiries. ... of unpaid or denied claims/charges. Rep is also responsible for providing outstanding customer service to both patients and staff members. Rep must be able to… more
- 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)
- Lead Customer Solution Center Appeals and Grievances Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, ... to achieve that purpose. Job Summary The Lead of Customer Solution Center Appeals...solutions to handle irate members, and provide optimal customer service for internal and external customers. Must be… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II (ALD) Job Category: Customer Service Department: CSC Appeals & Grievances Location: ... to support the safety net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will… 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 ... support the safety net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Nurse Specialist… more
- Insight Global (Los Angeles, CA)
- Job Description The Supervisor of the Customer Solution Center Appeals and Grievances is responsible for directly supervising and supporting the team ... -At least 3 years in a healthcare setting in Grievances and Appeals , Compliance, Claims or Call Center . -At least 2 years of leading process, program, or staff… more
- Insight Global (Los Angeles, CA)
- Job Description The Customer Solution Center Appeals and Grievances Specialist I will support the Appeals and Grievances team to receive, investigate ... (20%) -Supports the identification, investigation and resolve administrative complaints, simple appeals while adhering to Center for Medicare and Medicaid… more
- HCA Healthcare (Nashville, TN)
- …Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a Clinical Appeals Team Lead with Parallon you can be a part of an organization ... our organization. We are looking for an enthusiastic Clinical Appeals Team Lead to help us reach our goals....unresolved or have been escalated by the Shared Service Center (SSC) operations pre-established protocols. This position will be… more
- CVS Health (Austin, TX)
- …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
- LA Care Health Plan (Los Angeles, CA)
- …Preferred Required Training Physical Requirements Light Additional Information Department Specifics: Customer Solution Center Appeals and ... matter expertise in functional area to bridge business requirements and IT solutions ; provide technical direction and ensure compliance with best practice … more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Compliance Audit Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, ... net required to achieve that purpose. Job Summary The Customer Solution Center (CSC) Audit...minimum of 5 years of experience in regulatory auditing ( Appeals & Grievances, Call Center , Enrollment) in… more
- State of Colorado (Pueblo, CO)
- …promotes voluntary compliance with all tax laws through education, assistance and customer service. The Service Center serves about 200,000 customers each ... and assessments. + Promote voluntary compliance with tax laws through researching customer problems, identify solutions and needs, and take corrective actions… 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
- 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 (Melville, NY)
- … needs and concerns; demonstrate empathy and offer solutions . * Confirm customer understanding of the solution and provide additional customer education ... with member benefits, eligibility, claims inquiry, claim reconsiderations and appeals . This job description is not designed to cover...on ways to resolve problems to better serve the customer and/or improve productivity. * Offer solutions … more
- CVS Health (Richmond, VA)
- …may require coordination of responses from multiple business units. Ensure timely, customer focused response to appeals , complaints and grievance. Identify ... Anchored in our brand - with heart at its center - our purpose sends a personal message that...trends and emerging issues and report and recommend solutions . -Research incoming electronic appeals , complaints and… more
- State of Colorado (Lincoln County, CO)
- …Maintenance Specialist - Hugo Punkin Center Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4543035) Apply Highway Maintenance Specialist ... - Hugo Punkin Center Salary $52,356.00 - $53,000.00 Annually Location Lincoln County,...of Colorado and Colorado Workers for Innovative and New Solutions (COWins). If you have a Colorado Class A… more
