- CenterWell (Jackson, MS)
- **Become a part of our caring community and help us put health first** The Grievances & Appeals Representative 3 manages client denials and concerns by ... trained skillsets and/or partnerships with clinical and other Humana parties. The Grievances & Appeals Representative 3 performs advanced… more
- Evolent (Jackson, MS)
- …or GED is required. + Minimum of 3 years' experience in an Appeals and Grievances role or comparable administrative role within a health plan, managed ... Stay for the culture. **What You'll Be Doing:** The **Coordinator, Appeals and Grievances ** at Evolent is responsible for reviewing and processing case requests,… more
- Evolent (Jackson, MS)
- …**Required** + Minimum of 5 years in Utilization Management, health care Appeals , compliance and/or grievances /complaints in a quality improvement environment- ... for the culture. **What You'll Be Doing:** The Specialty Appeals Team offers candidates the opportunity to make a...to 7pm CST (which includes 30-minute unpaid lunch break) 3 days/week, to meet the business needs of nurses… more
- Cognizant (Jackson, MS)
- …or clinic operations . Experience in utilization management to include Clinical Appeals and Grievances , precertification, initial and concurrent reviews . ... . Maintain working knowledge of applicable health insurers' internal claims, appeals , and retro-authorization as well as timely filing deadlines and processes.… more