- Fallon Health (Worcester, MA)
- …other applicable regulatory requirements and member and provider expectations. The FH Appeals and Grievances Triage Administrator serves to administer the FH ... standards. The Triage Administrator is responsible for triaging and assigning all incoming appeals and grievances addressed to the Member Appeals &… more
- Fallon Health (Worcester, MA)
- …of Coverage, departmental policies and procedures, and regulatory standards. The Member Appeals & Grievances Intake Administrator is responsible for triaging and ... assigning all incoming appeals and grievances...acknowledgement of the grievance/appeal, educating the member and/or member representative about the grievance/appeal, gathering all pertinent and relevant… more
- VNS Health (Manhattan, NY)
- …receipt. Prepares letters requesting Appointment of Representative (AOR) forms in grievances and appeals filed on behalf of member representatives. Prepares ... triage tasks, including intake, classification, setup, and assignment of grievances and appeals . Additionally, provides administrative support to… more
- Point32Health (MA)
- …responsible for the accurate coordination, efficient administration and resolution of member appeals and member grievances submitted by Point32Health members for ... + Must be able to organize, plan and implement the functions of Member Appeals and Grievances , maintain timelines and turnaround times to meet multiple… more
- Concentrix (Albuquerque, NM)
- …their insurance related needs. Examples include: Inquiries regarding benefits, eligibility, appeals , grievances and troubleshooting medical devices. All while ... Job Title: Customer Service Representative (Healthcare) - Remote Job Description The Customer... (Healthcare) - Remote Job Description The Customer Service Representative (Remote) works from home and interfaces with customers… more
- Humana (Atlanta, GA)
- …Providers / Specialists, benefit coverages, authorizations, Provider claims inquiries, grievances and appeals , transportation needs, and pharmacy support. ... in a best-in-class contact center. As a Contact Center Representative 2, you will provide coverage for **Eastern Time...120 days of employment as an Inbound Contact Center Representative constitute an appraisal period. This Appraisal Period is… more
- The Cigna Group (Jackson, MS)
- …to various units for final processing + Independently respond to inquiries, grievances , complaints or appeals ranging from routine to moderate complexity. ... contact center environment. The Call Center Japanese speaking Customer Service Senior Representative represents the company; our people make all the difference in… more
- City of New York (New York, NY)
- …jurisdiction of the Department of Correction" - Investigate serious incidents - Review grievances from people in custody and staff - Evaluate the performance of the ... perform other duties as determined by the General Counsel. Appeals Under the Board's Minimum Standards, whenever DOC decides...requirement applies to you, please discuss with the agency representative at the time of interview. WORK LOCATION: 2… more
- State of Colorado (Denver, CO)
- …employment laws; progressive discipline; records management; recruitment; responding to grievances , appeals , charges of discrimination; reorganization issues; ... retention; selection and selection appeals ; settlement advice; strategic planning and overall HR guidance...the official appeal form, signed by you or your representative . This form must be delivered to the State… more
- State of Colorado (Denver, CO)
- …and guidance on issues that relate to performance management, progressive discipline, employee grievances and appeals , and civil rights. You will also be the ... the official appeal form, signed by you or your representative . This form must be delivered to the State...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
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