- AmeriHealth Caritas (Philadelphia, PA)
- …**This position is hybrid in Philadelphia, PA** **Job Summary** The Appeals & Grievance Case Resolution Specialist is responsible for the full life cycle ... of assigned member and/or provider appeals and grievance cases. Working under general... cases. Working under general supervision, this role conducts case intake, investigation, and documentation to ensure accurate and… more
- Humana (Harrisburg, PA)
- …roles include an overview of coding practices and clinical documentation, dispute, grievance , and appeals processes, and outpatient services and equipment, ... of business, member population, or condition type. May also engage in dispute, grievance , and appeals reviews. May participate on project teams or organizational… more
- Humana (Harrisburg, PA)
- …Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within ... in an assigned market, member population, or condition type. May also engage in grievance and appeals reviews. May participate on project teams or organizational… more