- Elevance Health (Woodland Hills, CA)
- **Title: Grievance / Appeals Analyst I** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles ... of one of our PulsePoint locations. The ** Grievance / Appeals Analyst I** is an entry level position in the Enterprise Grievance & Appeals Department… more
- Elevance Health (Indianapolis, IN)
- **Title: Grievances & Appeals Risk Analyst II** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 ... miles of one of our PulsePoint locations. The **Grievances & Appeals Risk Analyst II** will be responsible for providing support services for multiple states,… more
- Highmark Health (Harrisburg, PA)
- …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
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeal and Grievance Compliance Advisor Job Category: Administrative, HR, Business Professionals Department: CSC Appeals & Grievances ... documentation and categorization, service authorization request and coverage determination , Appeals and Grievances across all lines of business). This position is… more
- Elevance Health (Louisville, KY)
- **SCA Appeals Representative I** **Locations:** This is a virtual position. The ideal candidate must live within 50 miles of one of our NGS OR Elevance Health Pulse ... - $18.15 + Louisville, KY - $17.25 The **SCA Appeals Representative I** position is an entry-level position in...review tools to conduct extensive research and analyze the grievance and appeal issue(s) and pertinent claims and medical… more
- The Cigna Group (Nashville, TN)
- **Cigna Medicare Part C Appeals Reviewer: Appeals Processing Analyst ** We will depend on you to communicate some of our most critical information to the ... appeals and related issues, implications and decisions. The Case Management Analyst reports to the Supervisor/Manager of Appeals and will coordinate and… more
- Kelsey-Seybold Clinic (Pearland, TX)
- …Department of Insurance Regulations including working knowledge of member complaints, grievance , and appeals processing. Demonstrated ability to work ... plan types. It involves validating Annual & Biannual Reporting for both Appeals & Grievances and Enrollment teams, conducting Monthly and Quarterly Data Validation,… more
- CVS Health (Tallahassee, FL)
- …to make health care more personal, convenient and affordable. Position Summary As a Sr Analyst within the Grievance and Appeals DDAT Technology team you will ... the ideal candidate will be a detailed planner, expert communicator, and top-notch analyst . This person should also be wholly committed to the discovery and… more
- City of Lakeland (Lakeland, FL)
- HR Analyst - Policy and Employee/Labor Relations Print (https://www.governmentjobs.com/careers/lakelandfl/jobs/newprint/4429048) Apply HR Analyst - Policy and ... represents the City of Lakeland in unemployment claims and appeals hearings, securing the participation of the HR Director...you have experience in Public Sector collective bargaining and/or grievance handling? + Yes + No 11 Please provide… more
- Elevance Health (Palo Alto, CA)
- …Two (2) years of experience in health care, including prior authorization process and grievance and appeals process. * Two (2) years of experience with ... **IT Business System Analyst Sr Advisor** [AID020] **Location:** This position will...8:00 am to 5:00 pm The **IT Business System Analyst Sr Advisor** will collaborate with business and IT… more
- Centene Corporation (Raleigh, NC)
- …across several functional areas such as claims, enrollment, provider data management, grievance and appeals , sales and contracting. Advanced knowledge of ... Microsoft applications, including Excel and Access preferred. Project management experience preferred. Pay Range: $67,400.00 - $121,300.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock… more
- CVS Health (Lansing, MI)
- …obtain crucial or required information from Providers, such as HEDIS, Credentialing, Grievance and Appeals , SIU, etc. + Coordinates provider status information ... Position Summary + Lead a team of Medicaid Provider Data Services Analyst responsible for loading and maintaining Medicaid Provider data within Aetna QNXT.… more
- CVS Health (Austin, TX)
- …obtain crucial or required information from Providers, such as HEDIS, Credentialing, Grievance and Appeals , SIU, etc.- Coordinates provider status information ... hybrid in Texas** - Lead a team of Medicaid Provider Data Services Analyst responsible for loading and maintaining Medicaid Provider data within Aetna QNXT.- Team… more