• Appeals & Grievance Case Resolution…

    AmeriHealth Caritas (Philadelphia, PA)
    …. **This position is hybrid in Philadelphia, PA** **Job Summary** The Appeals & Grievance Case Resolution Specialist is responsible ... for the full life cycle of assigned member and/or provider appeals and grievance cases. Working under general supervision, this role conducts case intake,… more
    AmeriHealth Caritas (12/24/25)
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  • Intake Specialist Appeal…

    BayCare Health System (Clearwater, FL)
    …office required per week Equal Opportunity Employer Veterans/Disabled **Position** Intake Specialist Appeal and Grievance - Health Plan **Location** ... and clinical excellence. **Summary:** + Handles and processes customer appeals and grievances in accordance with established guidelines, company policies,… more
    BayCare Health System (01/09/26)
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  • Appeals Specialist I (Remote)

    CareFirst (Baltimore, MD)
    **Resp & Qualifications** **PURPOSE:** The Appeals Specialist I is responsible for the initial analysis of appeals and grievance correspondence, and ... breaching confidentiality of medical information. + Assists Supervisor and Appeals Specialist II and III with unit...with unit projects and other duties related to the appeals , grievance and/or reconsideration processes. Communicates with… more
    CareFirst (01/06/26)
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  • Specialist , Appeals & Grievances…

    Molina Healthcare (Bothell, WA)
    …claims appeals and grievances using support systems to determine appropriate appeals and grievance outcomes. * Requests and reviews medical records, notes, ... **Essential Job Duties** * Facilitates comprehensive research and resolution of appeals , disputes, grievances, and/or complaints from Molina members, providers, and… more
    Molina Healthcare (01/09/26)
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  • Managed Care Compliance Specialist

    Cedars-Sinai (CA)
    …CSHS employees on company policies and procedures regarding access to care, the grievance and appeals process, the eligibility process, etc. + Remains updated ... **Job Description** The Managed Care Compliance Specialist is responsible for assisting with the implementation...ID** : 11981 **Working Title** : Managed Care Compliance Specialist - Managed Care **Department** : MNS Managed Care… more
    Cedars-Sinai (12/11/25)
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  • CDOC Physician

    State of Colorado (CO)
    …referrals and consultations, medical reporting, medical co-signature and inmate grievance requirements are completed in accordance with DOC Administrative ... of the department's action. For more information about the appeals process, the official appeal form, and how to...position, please direct your inquiries to our Employee Relations Specialist , Kristen Lange , at doc_###@state.co.us or call ###… more
    State of Colorado (11/11/25)
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