• Grievance/ Appeals Representative I

    Elevance Health (Woburn, MA)
    **Grievance/ Appeals Representative I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... an accommodation is granted as required by law._ The **Grievance/ Appeals Representative I** is responsible for reviewing,...an impact:** + Conducts investigation and review of customer grievances and appeals involving provision of service… more
    Elevance Health (11/07/25)
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  • Member Intake Admin - Hybrid $22/hr

    Fallon Health (Worcester, MA)
    …of Coverage, departmental policies and procedures, and regulatory standards. The Member Appeals & Grievances Intake Administrator is responsible for triaging and ... assigning all incoming appeals and grievances...acknowledgement of the grievance/appeal, educating the member and/or member representative about the grievance/appeal, gathering all pertinent and relevant… more
    Fallon Health (11/12/25)
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  • Labor Relations Manager

    Transdev (Dorchester, MA)
    …of internal policies and procedures and regulations for accurate resolution of appeals , complaints, and grievances . + Understand legal requirements and ... + Manage the grievance process and provide comprehensive responses to complaints, grievances , and arbitrations that support the Company's decision and comply with… more
    Transdev (10/06/25)
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  • Pharmacy Coordinator

    Highmark Health (Boston, MA)
    …paid clams review. + Participate as pharmacy representative in onsite member appeals and grievances sessions. + Serve as a resource for technical staff. ... + Other duties as assigned or requested. **QUALIFICATIONS:** **Minimum** + High school diploma or GED + Experience in pharmacy prescription claims processing/submission/payment. **Preferred** + Associate degree + Pharmacy technician certification certificate +… more
    Highmark Health (10/16/25)
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  • CIC Registered Nurse - Hybrid

    Commonwealth Care Alliance (Boston, MA)
    …and supports, and community supports as approved + Supports escalation of member grievances and appeals + Supports the procurement of network providers and ... Standard office equipment Physical Requirements: + The physical demands described here are representative of those that must be met by an employee to successfully… more
    Commonwealth Care Alliance (10/02/25)
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