- Elevance Health (Durham, NC)
- **Manager II Grievance / Appeals ** **- Claims Support** **Office Locations:** _The selected candidate must reside within a reasonable commuting distance of the ... an accommodation is granted as required by law._ The **Manager II Grievance / Appeals ** responsible for management oversight of grievances and appeals … more
- Centene Corporation (Sacramento, CA)
- …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 or related managed care experience. Strong oral, written,… more
- Centene Corporation (Phoenix, AZ)
- …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 or related managed care experience. Strong oral, written,… more
- CVS Health (Columbus, OH)
- …Compliance experience. + 1+ years of External Audit Experience + 1+ years of Grievance and Appeals Experience **Education** + High School Diploma or GED ... matter and independently coaches others on matters regarding complaints and appeals , ensuring compliance with federal and/or state regulations. Ensures compliance… more
- Commonwealth Care Alliance (Boston, MA)
- …**Supervision Exercised:** No **Essential Duties & Responsibilities** Processing of Grievances & Appeals : + Responsible for the progress of grievance and appeal ... pharmacy, dental, reporting, and member services. + Supports the Senior Appeals & Grievance Coordinator and A/G Coordinator in day-to-day tasks and assignments.… more
- Centene Corporation (Austin, TX)
- … appeals and grievances from a clinical perspective. Ensure that the clinical Appeals and Grievance department processes all cases in accordance with policies ... perspective on workplace flexibility. POSITION IS REMOTE THIS TEAM PROCESSES APPEALS ONLY Appeals Experience HIGHLY Preferred **Position Purpose:** Supervise… more
- Point32Health (MA)
- …partners, colleagues and communities. **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Member Appeals and ... for the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual… more
- CVS Health (Baton Rouge, LA)
- …from multiple business units. Ensure timely, customer focused response to appeals , complaints and grievance . Responsible for day-to-day implementation of ... case load including but not limited to: -Research incoming electronic appeals , complaints and grievance to identify if appropriate for unit based upon published… more
- CVS Health (Hartford, CT)
- …AOA Recognized Specialty **Preferred Qualifications** * Medical Management - Medicare Complaints, Grievance & Appeals experience. * Health Plan Experience Highly ... of this Medical Director role are related to Medicare Appeals . * Direct daily work on part C ...Appeals . * Direct daily work on part C appeals (both provider and member/nonparticipating providers) * Provide direct… more
- Humana (Atlanta, GA)
- …Previous inbound call center or related customer service experience + Prior grievance and appeals experience + Previous experience processing medical ... and help us put health first** The Grievances & Appeals Representative 3 manages client denials and concerns by...review of clinical documentation to determine if an a grievance , appeal or further request is warranted and then… more
Related Job Searches:
Appeals,
Appeals Grievance Manager,
Director Grievance Appeals,
Grievance,
Grievance Appeals Analyst,
Grievance Appeals Coordinator,
Grievance Appeals Representative,
Manager Grievance Appeals RN,
Manager II Grievance/appeals,
Specialist Grievance Appeals