- Humana (Austin, TX)
- …of our caring community and help us put health first** The Grievances & Appeals Representative 3 manages client denials and concerns by conducting a ... with clinical and other Humana parties. The Grievances & Appeals Representative 3 performs advanced administrative/operational/customer support duties… more
- CVS Health (Austin, TX)
- …-Processes claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system. -Educates ... or Texas. Responsibilities below include, but not limited to: -Customer Service Representative is the face of Aetna and impacts members' service experience by… more
- CVS Health (Austin, TX)
- …-Processes claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system. -Educates ... we do it all with heart, each and every day. **Description** -Customer Service Representative is the face of Aetna and impacts members' service experience by manner… more
- CVS Health (Austin, TX)
- …contract. + Process claim referrals, new claim handoffs, nurse reviews, provider complaints, grievance and appeals via target system. + Assists providers with ... credentialing/re-credentialing and contracting questions and issues. + Assist in compiling claim data for audits. Determines medical necessity, applicable coverage provisions and verifies member plan eligibility relating to incoming correspondence and internal… more