- Evolent (Boston, MA)
- …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
- Commonwealth Care Alliance (Boston, MA)
- 011540 CCA- Appeals & Grievances **Position Summary** Appeals and Grievances Specialist supports the Operations Department and the Appeals and ... well as externally to facilitate timely resolution of all grievances and appeals and ensures compliance with...dental, reporting, and member services. + Supports the Senior Appeals & Grievance Coordinator and A/G … more
- Highmark Health (Boston, MA)
- …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