- AmeriHealth Caritas (Philadelphia, PA)
- …at www.amerihealthcaritas.com. **Position Overview:** The Appeals Specialist reports to the Supervisor of Appeals & Grievances and coordinates and ... and Part D drugs. ; **Key Responsibilities:** + Analyze and respond to appeals from members, member representatives, and providers regarding denials for services and… more
- CVS Health (Columbus, OH)
- …but not limited to customer service, claim, provider services, complaints, grievances , and appeals , implementation, and/or plan sponsor operations. Executes ... service solution for large plan sponsors. Our embedded and customer-dedicated service, clinical , and rising risk pods allow maximization of inbound and outbound… more
- State of Colorado (Denver, CO)
- …+ 1 - 2 years + Less than a year 03 How many years of experience do you have as clinical supervisor ? + 2 or more years + 1 - 2 years + Less than a year 04 How ... of health care including physical, psychiatric, and dental maintenance. Clinical Management: Functions as the facility responsible health authority (RHA).… more
- WellSpan Health (York, PA)
- …+ Resolves simple or informal complaints and refers formal grievances or appeals to appropriate officials. + Intercedes with supervisor on behalf of team ... all Technician level tasks. + Provides feedback to Logistics & Distribution Supervisor on co-worker's performance. Provides input to supervisor for performance… more
- Beth Israel Lahey Health (Westwood, MA)
- …information. Escalates calls to pharmacists for clinical inquiries and escalates grievances to supervisor . 7. Maintains new and existing patient profiles and ... Support health care providers with required prior authorization and required appeals . Manage all mail/delivery of Rx orders including addressing problems/issues with… more
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