• Senior Coordinator, Grievance & Appeals

    VNS Health (Manhattan, NY)
    …including intake, classification, setup, and assignment of grievances and appeals . Additionally, provides administrative support to staff, including tasks such ... as clinical case file preparation for appeals . This includes retrieving documents from related systems (such...Do + Identifies case types (eg- clinical vs non-clinical appeals ) during the intake process, communicates and responds to… more
    VNS Health (03/07/25)
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  • Manager, Grievance and Appeals , RN

    VNS Health (Manhattan, NY)
    …complexities of healthcare? VNS Health Plans is seeking a dedicated Manager, Grievance and Appeals (RN)to lead the daily operations of our grievance and appeals ... * Lead with Purpose: Manage day-to-day activities for staff handling grievances and appeals across our Managed Long Term Care (MLTC), Medicare Advantage (MA), or… more
    VNS Health (03/05/25)
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  • Appeals & Grievance Analyst

    Point32Health (MA)
    …colleagues and communities. **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Member 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 (05/01/25)
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  • Legal Billing Appeals Specialist

    Robert Half Accountemps (Houston, TX)
    Description Job Description: Billing Appeals Specialist (Short-Term Contract) Position Overview: Our client, a prominent legal firm, is seeking a Billing Appeals ... in reviewing denied billing claims, analyzing discrepancies, and filing appeals to ensure accurate and timely payments are received....errors in invoicing or reimbursement. + Prepare and Submit Appeals : Draft detailed and accurate appeals for… more
    Robert Half Accountemps (04/18/25)
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  • Member Appeals and Grievance Intake…

    Fallon Health (Worcester, MA)
    …on Facebook, Twitter and LinkedIn. **Brief summary or purpose:** Fallon Health (FH) Appeals and Grievance process is an essential function to FH's compliance with ... standards, other applicable regulatory requirements and member expectations. The FH Member Appeals and Grievance Intake Administrator serves to administer the FH … more
    Fallon Health (04/15/25)
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  • Appeals Specialist, Disability Claims

    Equitable (Charlotte, NC)
    Appeals Specialist, Disability Claims ( 25000066 ) **Primary Location** : UNITED STATES-NC-Charlotte **Other Locations** : UNITED STATES-Remote, UNITED ... will help unlock your potential? Equitable is seeking an influential and dynamic Appeals Specialist to join our Disability and Absence Claims organization. The … more
    Equitable (04/04/25)
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  • CHS Utilization and Appeals Coordinator

    Catholic Health Services (Melville, NY)
    …Island's Top Workplace! Job Details Position Summary: The Utilization and Appeals Coordinator will perform activities to help facilitate utilization management and ... appeals functions to include coordination of specific process and...Responsibilities: | Prepares necessary documentation for utilization management and appeals processes, performs data management and coordinates communication between… more
    Catholic Health Services (02/14/25)
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  • Appeals Case Manager II

    Guardian Life (Albany, NY)
    Guardian is seeking individuals with Group Disability claims experience to join our dynamic Appeals Team. The Appeals Case Manager II (ACM 2) is responsible for ... adjudicating assigned appeals for Group Life and Disability claims. The ACM...Short-Term Disability, Long-Term Disability and Life Waiver of Premium appeals . **Y** **ou are:** A highly motivated and reliable… more
    Guardian Life (05/02/25)
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  • Customer Solution Center Appeals

    LA Care Health Plan (Los Angeles, CA)
    Customer Solution Center Appeals and Grievances Specialist I Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, ... achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Specialist I primary function is to...I primary function is to learn the specialty level appeals and grievances work supporting the higher level position… more
    LA Care Health Plan (04/28/25)
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  • Customer Solution Center Appeals

    LA Care Health Plan (Los Angeles, CA)
    Customer Solution Center Appeals and Grievances Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, ... required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve member… more
    LA Care Health Plan (03/26/25)
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