- CVS Health (Columbus, OH)
- …do** + Prepares and participates in external and internal audits. + Analyzes basic quality and completeness of the complaints and appeals documentation to ensure ... changes, as well as new training programs to drive quality results. + Assists in analyzing patterns, trends, and...years of External Audit Experience + 1+ years of Grievance and Appeals Experience **Education** + High… more
- Highmark Health (Columbus, OH)
- …of a grievance /appeal; documents, investigates, refers and coordinates grievances and appeals ; initiates a case file for each grievance and appeal; ensures ... Review inquiries to determine if they meet definition of appeal/ grievance . + Request and review all related relevant documentation...+ Participate in workgroup meetings to address trends in appeals and grievances and to work on process improvement… more