- BroadPath Healthcare Solutions (Tucson, AZ)
- **Overview** BroadPath is excited to announce that we are hiring **Work from Home Appeals and Grievance Specialists** . The Appeals and Grievance ... a key role in helping members navigate and understand their benefits related to Appeals , External Medical Review, and the Fair Hearing process. Acts as the first… more
- Harbor Health Services, Inc. (Mattapan, MA)
- …knowledge of all aspects of managed care medical management including UM/CM, Grievance and Appeals , inpatient and outpatient services, medical policy, and ... process improvement, communication to employees about QI efforts. Working with the Appeals and Grievances Specialist, maintains oversight of the Grievances and … more
- UTMB Health (Galveston, TX)
- …action. Provides advice and guidance to managers regarding the employee grievance and appeals processes. Administers, interprets, communicates, and leads ... training regarding various human resources policies, procedures, federal and state employment laws, and initiatives that impact the work environment to management and employees. Serves as the employee relations expert to HR Business Partners and other HR… more
- State Bar of Texas (Houston, TX)
- …Commission for Lawyer Discipline in attorney disciplinary proceedings before District Grievance Committees, District Courts, and the Board of Disciplinary Appeals ... in attorney discipline litigation, including hearings before evidentiary panels of the grievance committee, district court trials and proceedings before the Board of… more
- Elevance Health (Cerritos, CA)
- **Title: Grievance / Appeals Analyst I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... for employment, unless an accommodation is granted as required by law._ The ** Grievance / Appeals Analyst I** is an entry level position in the Enterprise … more
- Centene Corporation (Harrisburg, PA)
- …member and provider complaints, grievances and appeals + Maintain files on individual appeals and grievances + May coordinate the Grievance and Appeals ... High school diploma or equivalent. Associate's degree preferred. 2+ years grievance or appeals , claims, related managed care experience, or… more
- Elevance Health (Mason, OH)
- …by medical directors and consultants; preparing recommendations to uphold or deny appeals ; and ensuring all grievance processes are completed within regulatory ... legal proceedings, and/or paralegal experience is strongly desired. .Understanding of the grievance and appeals process is strongly preferred. .Basic knowledge… more
- CVS Health (Columbus, OH)
- …compassionate. And we do it all with heart, each and every day. **Position Summary** Enter grievance and appeals cases into the G&A system to launch the case for ... - Working knowledge of problem solving and decision making skills. - Grievance and appeals experience. **Preferred Qualifications** Health Insurance Call Center… more
- Point32Health (FL)
- …Point32Health (https://www.point32health.org/) . **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Appeals and ... for the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual… more
- Henry Ford Health System (Troy, MI)
- …for the prompt and thorough investigation of medical and pharmacy member appeals and grievances for Health Alliance Plan's (HAP's): Commercial, Medicare Advantage, ... + Conduct the primary investigation and resolution of member appeals and grievances following established guidelines from: The Center...as part of their onboarding to the Appeal and Grievance Team. + Perform other related duties as assigned.… more
