- Trinity Health (Columbus, OH)
- …financial analysis, audit, provider relations and more. **Position Purpose:** The Appeals and Grievance Coordinator is responsible for the processing and ... resolution of appeals , grievances and disputes from members and providers **What You Will Do:** + Document all appeal requests or grievances upon receipt in… more
- Fallon Health (Worcester, MA)
- …NCQA standards, other applicable regulatory requirements and member expectations. The FH Member Appeals & Grievances Coordinator serves to administer the FH ... Coverage, departmental policies and procedures, and regulatory standards. The Member Appeals & Grievances Coordinator serves as a liaison between FH members… more
- Centene Corporation (Bedford, NH)
- …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
- Baylor Scott & White Health (Temple, TX)
- … and Grievance Coordinator is responsible for intake into the Appeals and Grievances Department, including verbal and written complaints, grievances ... Intakes and processes written and fax referred cases from member and provider appeals and complaints for all lines of business, ensuring compliance with applicable… 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
- Centene Corporation (Baton Rouge, LA)
- …expectations and lead clinical quality initiatives. Review clinical information for appeals to determine medical necessity of services, prepare reviews for cases, ... act as the liaison for appeals and fair hearings. + Develop and implement the...and resolve behavioral health quality of care complaints and grievances + Performs other duties as assigned + Complies… more
- Centene Corporation (Tacoma, WA)
- …expectations and lead clinical quality initiatives. Review clinical information for appeals to determine medical necessity of services, prepare reviews for cases, ... act as the liaison for appeals and fair hearings. + Develop and implement the...and resolve behavioral health quality of care complaints and grievances + Performs other duties as assigned + Complies… more
- Norfolk Southern (Atlanta, GA)
- …administrative support services and processes throughout the department while also handling the appeals of claims and grievances and the defense of management's ... Asst. Labor Relations Officer & Coordinator Apply now " **Date:** Jun 16, 2025...Norfolk Southern Corp. Requisition38408:B3 Asst. Labor Relations Officer & Coordinator **_A resume helps you stand out to hiring… more
- Elevance Health (Akron, 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 ** **Hiring statewide across Ohio** **Location** : This...services and supports, and psychosocial needs. The **LTSS Service Coordinator ** is responsible for managing service coordination for a… more
- Elevance Health (West Palm Beach, 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 (Bilingual in Spanish/English)** **Schedule:** Monday-Friday 8am-5pm **Location** _:_ This is primarily a field based position. Candidate… 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
- State of Colorado (Pueblo, 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.us or call ###. ~THE… more
- State of Colorado (Golden, CO)
- …This supervision entails assigning and evaluating work, handling informal grievances , initiating corrective and disciplinary actions, and participating in the ... This supervision entails assigning and evaluating work, handling informal grievances , initiating corrective and disciplinary actions, and participating in the… 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)
- …conflicts, investigates and problem solves internal and external complaints and grievances from staff, youth, family, and other customers. Scheduling of clinic ... of the department's action. For more information about the appeals process, the official appeal form, and how to...this position, please direct your inquiries to our ADAA Coordinator , Nancy Schmelzer, at cdhs_###@state.co.us or call ###. ~THE… more