- Evolent (Austin, TX)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The ** Coordinator , Appeals and Grievances ** at Evolent is responsible for reviewing ... prior authorization experience. This role is distinct from other coordinator positions in that it is dedicated to case...required. + Minimum of 3 years' experience in an Appeals and Grievances role or comparable administrative… more
- CVS Health (TX)
- …Prepares information and reports needed to address matters regarding complaints, appeals , and grievances . Carries out policies, procedures, and programs ... state regulations. **What you will do** + Reviews, and processes appeals and grievances filed by patients. + Assists with adherence to regulatory requirements,… more
- Elevance Health (Corpus Christi, TX)
- …Law Enforcement). + Assists and participates in appeal or fair hearings, member grievances , appeals , and state audits. **Minimum Requirements:** + Requires BA/BS ... the Dallas/Ft. Worth, TX or Nueces, TX areas** The **LTSS Service Coordinator ** is responsible for conducting service coordination functions for a defined caseload… more
- Highmark Health (Austin, TX)
- …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