- Molina Healthcare (St. Petersburg, FL)
- …apply state level requirements to meet contract and regulatory expectations. * Establishes Appeals & Grievances department policies and procedures in line with ... and interprets trends and prepares reports that identify root causes for Appeals , Grievances , and Provider Disputes. Recommends and implements process… more
- Molina Healthcare (Jacksonville, FL)
- …and directing the activities of the Medicare Contracted Provider Post-Pay Claim Appeals and Disputes in accordance with the standards and requirements established by ... the activities of the Medicare Contracted Provider Post-Pay Claim Appeals and Disputes that is responsible for reviewing and... and grievance processing/resolution, including 2 years in a manager role. * Experience reviewing all types of medical… more
- Elevance Health (FL)
- …an accommodation is granted as required by law._ The ** Manager II Grievance/ Appeals ** responsible for management oversight of grievances and appeals ... ** Manager II Grievance/ Appeals ** **- Claims Support**...departmental units to investigate, resolve, and respond to grievances and appeals , manages inventory and production… more
- Molina Healthcare (Tampa, FL)
- …and Marketplace request authorization. Strongly prefer candidates with a background in appeals and grievances . Excellent computer multi-tasking skills and good ... office with internet connectivity of high speed required **Job Summary** Clinical Appeals is responsible for making appropriate and correct clinical decisions for … more
- CHS (Clearwater, FL)
- …client trust. * Investigates and participates in formal responses relating to complaints, grievances and appeals received by or applicable to PAS. Participates ... **Overview** **Claims Manager ** **Servicing** **Health Insurance Policies or Benefits** **Summary:**...stated coverage. Join Premier Administrative Solutions as a Claims Manager and lead our Claims Department in delivering exceptional… more
- Elevance Health (St. Petersburg, FL)
- …Law Enforcement). + Assists and participates in appeal or fair hearings, member grievances , appeals , and state audits. **Minimum Requirements:** + Requires BA/BS ... in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance Health location at least… more
Recent Jobs
-
Southeast - Survey Manager - Fort Lauderdale
- Kiewit (Fort Pierce, FL)
-
Designated Litigation Manager - Pooling (Self Insured Public Entities)
- Sedgwick (Southfield, MI)
-
Weekend Sales Associate
- Michaels (Washington, DC)
-
Senior Manager, Talent Business Partner
- Wayfair (Boston, MA)