- Evolent (Sacramento, CA)
- …Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The ** Coordinator ** **,** ** Appeals and Grievances ** at Evolent will serve as a ... point of contact for processing post determination reviews and appeals requests in accordance with departmental policies, regulatory requirements, and client… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Coordinator I(Temp) Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los ... required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Coordinator I supports the Customer Solution Center … more
- Centene Corporation (Sacramento, CA)
- …and authorization appeals from providers and pursue resolution of formal grievances from members. + Gather, analyze and report verbal and written member and ... provider complaints, grievances and appeals + Prepare response letters for member and provider complaints, grievances and appeals + Maintain files on… more
- Highmark Health (Sacramento, CA)
- …through paid clams review. + Participate as pharmacy representative in onsite member appeals and grievances sessions. + Serve as a resource for technical ... staff. + Other duties as assigned or requested. **QUALIFICATIONS:** **Minimum** + High school diploma or GED + Experience in pharmacy prescription claims processing/submission/payment. **Preferred** + Associate degree + Pharmacy technician certification… more
- The County of Los Angeles (Los Angeles, CA)
- …personnel in their unit and effectively recommending the adjustment of grievances and disciplinary problems. Other positions are assigned such functions as: ... first level technical and administrative supervision to the complaint or advanced-level appeals unit. Essential Job Functions + Supervises the activities of all… more