• Appeals and Grievance Analyst

    Point32Health (GA)
    …(https://www.point32health.org/) . **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Appeals and Grievance Analyst ... the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual works… more
    Point32Health (12/09/25)
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  • Pharmacy Coordinator

    Highmark Health (Atlanta, GA)
    …of benefit billing practices through paid clams review. + Participate as pharmacy representative in onsite member appeals and grievances sessions. + Serve as ... medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary and prior… more
    Highmark Health (12/18/25)
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