- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Customer Solution Center Appeals and Grievances (Temporary) Job Category: Administrative, HR, Business Professionals Department: CSC ... required to achieve that purpose. Job Summary The Supervisor, Customer Solution Center Appeals...independently. Ability to solve complex issues and identify creative solutions . Computer ease and literacy with Microsoft Office (Word,… 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 ... to support the safety net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Specialist I primary function… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist III Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los ... and to support the safety net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Specialist III will… 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 ... to support the safety net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will… more
- LA Care Health Plan (Los Angeles, CA)
- Manager, Customer Solution Center Appeals and Grievances Job Category: Management/Executive Department: CSC Appeals & Grievances Location: Los ... support the safety net required to achieve that purpose. Job Summary The Manager, Customer Solution Center Appeals and Grievances is responsible for the… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Quality Auditing Specialist II Job Category: Administrative, HR, Business Professionals Department: CSC ... support the safety net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Quality Auditing (QA) Specialist… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Training Development Specialist III Job Category: Administrative, HR, Business Professionals Department: ... achieve that purpose. Job Summary The Customer Solution Center (CSC) Appeals and...technical or complex content into accessible and engaging learning solutions . Work with the quality team on quality and… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Audit Readiness Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, ... net required to achieve that purpose. Job Summary The Customer Solution Center (CSC) Audit...minimum of 5 years of experience in regulatory auditing ( Appeals & Grievances, Call Center , Enrollment) in… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …physicians, hospitals, and other healthcare providers with member benefits, eligibility, and appeals . The Customer Service Representatives must be able to work ... and communicate effectively with teams. + Transfer misdirected requests and offer solutions to non-routine issues. + Contribute to customer satisfaction and… more
- TEKsystems (Orlando, FL)
- …skills. + Ability to work independently in a remote environment. + Previous call center or customer service experience preferred. Pay and Benefits The pay range ... Bilingual Call Center Representative (English/Spanish) 100% Remote Schedule: Monday-Friday, 9:45...a fast-paced environment and is passionate about delivering exceptional customer service. Key Responsibilities: + Handle inbound calls from… more
- US Tech Solutions (RI)
- …inquiries to the pharmacist team as appropriate. **Experience:** + 0-3 years in a customer service or call center environment managing 75 calls/day. + Six months ... and/or resolve coverage requests. + Escalate issues to Coverage Determinations and Appeals Learning Advocates and management team as needed. + Must maintain… more
- TEKsystems (Harrisburg, PA)
- …Experience with computer applications, such as Microsoft Word and PowerPoint. Previous customer service/call center experience is required. Pay and Benefits The ... to inbound calls and process inquiries from providers and members. - Resolve customer service or billing issues under general supervision, using sound judgment. -… more
- Zions Bancorporation (Midvale, UT)
- …is an investment in our customers and our business. Your Purpose + Help every customer feel valued by your words and actions + Inspire our customers to tell someone ... about their positive experience + Deliver meaningful solutions for our customers through inbound phone interactions + Seek to add value to each customers' experience… more
- TEKsystems (Orlando, FL)
- …to inbound calls and process inquiries from providers and members. - Resolve customer service or billing issues under general supervision, using sound judgment. - ... or inform them of claim investigation outcomes. - Refer unresolved grievances, appeals , and claim resolutions to appropriate departments. - Maintain records of … more
- Whitney Young Health Center (Albany, NY)
- …payers via phone or website, contacting practices, navigating cross-departmentally, writing appeals and facilitating their direction to Athena CBO for submission, ... required by WYH for employment purposes and co-pays when appropriate. + Develops solutions to claim processing and payer adjudication problems. + Learn and keep up… more
- Cleveland Clinic (Cleveland, OH)
- …thorough benefits investigation and processes any necessary prior authorizations and/or appeals for pharmacy claims. + Explain benefit coverage and financial ... physician of results as needed. + Communicate with patients professionally and customer -friendly to schedule the delivery of new and refilled medications and… more
- Iowa Department of Administrative Services (Des Moines, IA)
- …IA Job Type Full-time Job Number 25-03411 Agency 427 Department of Inspections, Appeals & Licensing Opening Date 06/10/2025 Closing Date 6/22/2025 11:59 PM Central ... issues. The Administrative Assistant 2 will be responsible for customer service, explaining our processes to the people we...will also be responsible for promptly and correctly docketing appeals for the Board which includes, but is not… more
- CVS Health (Lansing, MI)
- …are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital ... Anchored in our brand - with heart at its center - our purpose sends a personal message that...culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and… more
- CVS Health (Hartford, CT)
- …constituents expectations are met or exceeded. + Identifies trends and any emerging customer service issues and works to develop solutions to address potential ... about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our...member to ensure you are providing the most complete customer service experience that you can for our members.… more
- US Tech Solutions (RI)
- …etc. 5% **Experience:** Preferred 0-3 years work experience required in a customer service position with high volume call center experience; preferably ... with other internal groups regarding determination status and results (seniors, pharmacists, appeals , etc.). 10% + Identify and elevate clinical inquiries to the… more