- Baylor Scott & White Health (Temple, TX)
- **JOB SUMMARY** The Appeals and Grievance Specialist performs reviews, within operational aspects, of the member and provider complaints, appeals and ... of cases; review, research and coordination of complaints, grievances, appeals and reconsiderations consistent with statutory and federal regulatory guidelines.… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …referrals generated to care management programs + Provides administrative support to the grievance and appeals process within the + Medical Services department ... on the specific tasks assigned, the Medical Services Coordination Specialist provides administrative support for any of the programs...Plan Essential Accountabilities: Level I + Review / prep clinical case for clinical staff. + Navigates… more
- LA Care Health Plan (Los Angeles, CA)
- …track all due dates for each file. Inform nurses of a new case received from Grievance and Appeals Specialist .; submit all Grievances and Appeals ... Authorization Technician II (12 Month Assignment) Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full… more
- State of Colorado (Denver, CO)
- …PT 1587/8239 Physician 10/2025 Department Department of Corrections Division Clinical and Correctional Services Opening Date 10/14/2025 Closing Date 11/10/2025 ... on-call assessment, diagnosis, and treatment of inmates in one or more prison clinical settings. Physicians are responsible for, but not limited to, the following: +… more
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