- Molina Healthcare (Macon, GA)
- …with research. * Determines appropriate language for letters and prepares responses to member appeals and grievances . * Elevates appropriate appeals to the ... in an efficient and timely manner. * Creates and/or maintains appeals and grievances related statistics and reporting. * Collaborates with provider and member… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist I (Temporary) Job Category: Customer Service Department: CSC Appeals & Grievances ... achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Specialist I...High School Diploma/or High School Equivalency Certificate Education Preferred Associate 's Degree Experience Required: At least 1 year of… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II (Temporary) Job Category: Customer Service Department: CSC Appeals & Grievances ... safety net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Appeals Specialist I is responsible for the initial analysis of appeals and/or grievance correspondence, and ... and tracking information to facilitate and expedite processing of appeals and/or grievances received from a variety...breaching confidentiality of medical information. + Assists Supervisor and Appeals Specialist II and III with unit… more
- Molina Healthcare (OH)
- …Represents Member issues in areas involving member impact and engagement including: Appeals and Grievances , Member Problem Research and Resolution, and the ... or problem; informs members of their rights in the complaints and appeals process; and advises/refers as appropriate for investigation and resolution. * Conducts… more
- Staffing Solutions Organization (Albany, NY)
- …clarification of policies and procedures which may include marketing, enrollment, grievances and appeals , provider/plan education, and quality monitoring ... is a reflection of our clients and the people they serve. **Healthcare Data Specialist 1 in Albany, NY** **Division of Health Plan Contracting & Oversight (DHPCO)… more
- Commonwealth Care Alliance (Boston, MA)
- …schedule issues. + Collaborate closely with Provider Relations, Contracting, Payment Integrity, Appeals & Grievances , and Configuration teams to validate and ... Education (must have):** + N/A **Desired Education (nice to have):** + Associate 's or Bachelor's degree in Health Administration, Finance, or related field… more
- Volunteers of America Los Angeles (Los Angeles, CA)
- …and resolution of facts and issues in matters affecting disciplinary actions, grievances , appeals , and complaints, refers complex matters to HR Employee ... People Relations Partner Associate III Location:Los Angeles, CA Job ID:4053 Salary:$80116.92...Relations Specialist or Senior Manager of Employee Relations as required… more
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