- 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
- Fallon Health (Worcester, MA)
- …us on Facebook, Twitter and LinkedIn. **Brief summary or purpose:** Fallon Health (FH) Appeals and Grievance process is an essential function to FH's compliance ... standards, other applicable regulatory requirements and member expectations. The FH Member Appeals and Grievance Intake Administrator serves to administer the FH… more
- VNS Health (Manhattan, NY)
- …to established procedures. Maintains confidentiality of information. + Maintains knowledge of Grievance and Appeals (G&A) procedures, and CMS and DOH regulatory ... of Liability form, follows-up and tracks receipt. Prepares letters requesting Appointment of Representative (AOR) forms in grievances and appeals filed on behalf… more
- Fallon Health (Worcester, MA)
- …and appeals , which includes,sending the appropriate acknowledgment of the grievance /appeal, educating the member and/or member representative about the ... For more information, visit fallonhealth.org. **Brief Summary of Purpose:** Fallon Health's (FH) Appeals and Grievance process is an essential function to FH's… more
- Independent Health (Buffalo, NY)
- …ICD-9-CM, ICD-10-CM and HCPCS coding preferred. + Experience in compliance regulations, appeals and grievance knowledge preferred. + Ability to effectively ... paid time off (PTO), including company paid holidays. The Provider Relations Representative position offers an opportunity to begin a career at Independent Health.… more
- CVS Health (Columbus, OH)
- …-Processes claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system. -Educates ... EST Time Zone. Responsibilities below include, but not limited to: -Customer Service Representative is the face of Aetna and impacts members' service experience by… more
- CVS Health (Raleigh, NC)
- …Processes claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system. + Educates ... available to work between M-F 8-530pm EST** **Position Summary** + Customer Service Representative is the face of Aetna and impacts members' service experience by… more
- BrightSpring Health Services (Nashville, TN)
- …to Member and Provider issues. Refer all unresolved issues to the next level including grievance and appeals . + Actively market plan to new senior care partners ... Our Company Signature Advantage Overview Seeking an Account Representative for our Signature Advantage Plan who will work with senior care partners to assist in… more
- New York State Civil Service (Albany, NY)
- …rules, regulations and case law. The incumbent serves as the Chancellor's representative in hearing appeals of disciplinary and contract grievances pursuant ... relations policy for classified service employees.- Serves as the University's representative in the administration of the grievance procedures (contract,… more
- TAD PGS, Inc. (Chicago, IL)
- …employee grievance and disciplinary matters. + Oversees matters related to the Employee Appeals Board and acts as Representative of the Employee Appeals ... Board. + Counsels various departments and offices in labor relations and employment matters such as discipline, layoffs, terminations, transfers, and numerous other matters that may arise between management and employees/unions. + Provides advice and counsel… more
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