- Insight Global (Tustin, CA)
- Job Description An employer is looking for a remote Appeals & Grievances Coordinator who will be responsible for managing and resolving appeals and ... teams and external stakeholders. Key Responsibilities - Review, research, and process appeals and grievances in compliance with company policies and regulatory… more
- LA Care Health Plan (Los Angeles, CA)
- Registered Nurse (RN) Manager, Appeals and Grievances General Operations (Clinical) Job Category: Clinical Department: CSC Appeals & Grievances Location: ... safety net required to achieve that purpose. Job Summary The Manager, Appeals & Grievances (A&G) & General Operations (Clinical) is responsible for the daily… more
- Sanford Health (Sioux Falls, SD)
- …governing appeals and grievance resolution. Lead and manage the end-to-end appeals and grievances process for all product lines, ensuring compliance with ... Oversee the intake, review, resolution, and documentation of all appeals , complaints, and grievances to meet regulatory...and documentation of all appeals , complaints, and grievances to meet regulatory and operational standards. Ensure all… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist I (Temporary) Job Category: Customer Service Department: CSC Appeals & Grievances Location: ... required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Specialist I primary function is to learn the specialty level … more
- LA Care Health Plan (Los Angeles, CA)
- Lead Customer Solution Center Appeals and Grievances RN Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 ... to achieve that purpose. Job Summary The Lead Customer Solution Center Appeals and Grievances RN is responsible for assisting with the development of a… more
- Molina Healthcare (San Antonio, TX)
- …**Essential Job Duties** * Facilitates comprehensive research and resolution of appeals , disputes, grievances , and/or complaints from Molina members, providers, ... that internal and/or regulatory timelines are met. * Researches claims appeals and grievances using support systems to determine appropriate appeals and… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II (Temporary) Job Category: Customer Service Department: CSC Appeals & Grievances Location: ... to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve member and… more
- Point32Health (MA)
- …responsible for the accurate coordination, efficient administration and resolution of member appeals and member grievances submitted by Point32Health members for ... to organize, plan and implement the functions of Member Appeals and Grievances , maintain timelines and turnaround times to meet multiple requirements/regulations… more
- Dignity Health (Rancho Cordova, CA)
- …This position is hybrid in-office and work from home.** **Position Summary:** The Appeals and Grievances Coordinator is responsible for supporting the appeals ... with regulatory requirements - facilitating timely and effective resolution of appeals and grievances . Acting a subject matter expert (SME), the Coordinator will… more
- Dignity Health (Rancho Cordova, CA)
- **Job Summary and Responsibilities** The Appeals and Grievances LVN is a critical role responsible for managing and resolving all medical necessity appeal ... and maintaining patient confidentiality (HIPAA) are also essential. Ultimately, the Appeals and Grievances Nurse monitors denial trends, recommends corrective… more
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