- 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 ... employment, unless an accommodation is granted as required by law._ The **Grievance/ Appeals Analyst I** is an entry level position in the Enterprise Grievance &… more
- Point32Health (MA)
- …the general direction of the Member Appeals and Grievance Supervisor the Appeals and Grievance Analyst is responsible per State and Federal regulations for ... the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual works… more
- Point32Health (Canton, MA)
- …general direction of the Member Appeals and Grievance Supervisor the Member Appeals and Grievance Analyst is responsible per State and Federal regulations ... the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual works… more
- Elevance Health (Tampa, FL)
- …for system edits. + Coordinates research and responds to system inquiries and appeals . + Conducts research of claims systems and system edits to identify ... adjudication issues and to audit claims adjudication for accuracy. + Perform pre-adjudication claims reviews to ensure proper coding was used. + Prepares correspondence to providers regarding coding and fee schedule updates. + Trains customer service staff on… more
- CVS Health (Albany, NY)
- …This person will be responsible for curating, leading, and providing oversight of our proficiency program. This includes planning, executing, and supervising ... departmental projects to ensure they are completed within scope and aligned with organizational objectives. **Functional Components** + Collaborating with account executives to resolve any member or plan sponsor complaints. + Communicates professionally and… 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, ... Medicare-Medicaid Program (MMP), and Medicaid lines of business. Analyst must identify trending issues on an ongoing basis and provide root/cause analysis when… more
- Ochsner Health (New Orleans, LA)
- …make a difference at Ochsner Health and discover your future today!** The Appeals Specialist is responsible for managing and resolving insurance claim denials and ... Collaborate with clinical staff and coding teams to obtain necessary documentation for appeals + Track and monitor appeal status, maintaining detailed records in the… more
- Elevance Health (Mason, OH)
- **Grievance and Appeals Analyst II (Executive Concierge Analyst )** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering ... an accommodation is granted as required by law. The **Grievance and Appeals Analyst II** is responsible for providing support services for multiple states,… more
- MTA (Long Island City, NY)
- … Analyst Series (Paratransit) Department: Paratransit Division/Unit: No-Show/Late Cancellation Appeals Reports To: Sr. Dir Paratransit SVC Eligibility Appeals ... - Represented by TWU): Min: $71,203 - Max: $84,295 No-Show/Late Cancellation Appeals As a Staff Analyst , you'll support the appeals process for no-show and… more
- HCA Healthcare (Nashville, TN)
- **Description** **Introduction** Do you have the career opportunities as a Benefits Analyst you want with your current employer? We have an exciting opportunity for ... caring group of colleagues. Do you want to work as a Vendor Relations Analyst where your passion for creating positive patient interactions is valued? If you are… more
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