- Centene Corporation (Bedford, NH)
- …member and provider complaints, grievances and appeals + Maintain files on individual appeals and grievances + May coordinate the Grievance and Appeals ... High school diploma or equivalent. Associate's degree preferred. 2+ years grievance or appeals , claims or related managed care experience. Strong oral, written,… more
- Centene Corporation (Phoenix, AZ)
- …member and provider complaints, grievances and appeals + Maintain files on individual appeals and grievances + May coordinate the Grievance and Appeals ... High school diploma or equivalent. Associate's degree preferred. 2+ years grievance or appeals , claims or related managed care experience. Strong oral, written,… more
- Commonwealth Care Alliance (Boston, MA)
- …clinical, operations, pharmacy, dental, reporting, and member services. + Supports the Senior Appeals & Grievance Coordinator and A/G Coordinator ... No **Essential Duties & Responsibilities** Processing of Grievances & Appeals : + Responsible for the progress of grievance... Appeals : + Responsible for the progress of grievance and appeal intervention and resolution. + Assure verbal… more
- Baylor Scott & White Health (Temple, TX)
- **JOB SUMMARY** The Appeals and Grievance Coordinator is responsible for intake into the Appeals and Grievances Department, including verbal and written ... complaints, grievances and requests for appeals that involve complex matters submitted by Members and...of all regulatory requirements as they apply to complaint, grievance and appeal processes. + Proficient in Microsoft applications,… more
- Trinity Health (Columbus, OH)
- …technology, financial analysis, audit, provider relations and more. **Position Purpose:** The Appeals and Grievance Coordinator is responsible for the ... + Responsible for ensuring 5-Star (maximum) ratings from CMS for appeals and grievance related measures. STAR ratings have a direct correlation on payment… more
- CVS Health (Oklahoma City, OK)
- …of responses from multiple business units. Ensure timely, customer focused response to appeals , complaints and grievance . Identify trends and emerging issues and ... report and recommend solutions. -Research incoming electronic appeals , complaints and grievance to identify if appropriate for unit based upon published business… more
- Fallon Health (Worcester, MA)
- … Appeals & Grievances Coordinator serves to administer the FH Appeals and Grievance process as outlined in the Member Handbook/Evidence of Coverage, ... LinkedIn. **Brief summary of purpose:** The Fallon Health (FH) Appeals and Grievance process is an essential...departmental policies and procedures, and regulatory standards. The Member Appeals & Grievances Coordinator serves as a… more
- CoreCivic (Leavenworth, KS)
- …and a responsibility to better the public good. We are currently seeking a ** Grievance Coordinator ** who has a passion for providing the highest quality care ... dedicated to making an impact for the people and communities we serve. The Grievance Coordinator oversees the inmate/resident grievance process and ensures… more
- Conduent (East Hartford, CT)
- …be part of a culture where individuality is noticed and valued every day. ** Appeals Coordinator - Customer Experience Associate IV** **Summary:** As an ** ... Appeals Coordinator - Customer Experience** analyze and...+ Identify and report error trends discovered during the Grievance Mediation process to the Quality Assurance Supervisor. +… more
- Roper St. Francis (Charleston, SC)
- …Day shift 8:00am-5:00pm** **Job Summary** **:** The Patient Relations & Legal Coordinator aids in complaints and grievances management as well as legal matters ... resolutions, receives & forwards compliments, issues acknowledgement letters, forwards grievance forms within the designated timeframe, assists with accreditation… more
- University of Colorado (Aurora, CO)
- …human resources, and university leadership. + Address faculty concerns regarding professionalism, grievance procedures, and appeals processes and serve as a ... with annual performance reviews, post-tenure reviews, professionalism policies, and grievance processes. + Interpret and apply faculty policies (eg, faculty… more
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