- CVS Health (Oklahoma City, OK)
- …initiation of appeal process. -Identify and research all components within member or provider/practitioner appeals, complaints and grievance for all products ... -Responsible for coordination of all components of appeals, complaints and grievance including final communication to member /provider for final resolution… 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 ... Purpose:** Analyze and resolve verbal and written claims and authorization grievance /appeals from providers and members. Resolve all State inquires related to… more
- Commonwealth Care Alliance (Boston, MA)
- …completion of member verbal and written correspondence. + Thoroughly document all member appeal and grievance related interactions and interventions into ... member services. + Supports the Senior Appeals & Grievance Coordinator and A/G Coordinator ...needed. + Supports the maintenance of updated data in Appeal / Grievance application of the member … 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 ... Services contracted reviewer. Job Duties + Prepares and facilitates Member appeals, complaints and grievances by communicating directly with...+ Acts as the primary resource regarding the complaint, appeal and grievance processes to all other… more