- Evolent (Austin, TX)
- …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
- 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