- CVS Health (Frankfort, KY)
- …units. Ensure timely, customer focused response to appeals, complaints and grievance . Identify trends and emerging issues and report and recommend solutions. ... -Research incoming electronic appeals, complaints and grievance to identify if appropriate for unit based upon published business responsibilities. Identify correct… more
- Fallon Health (Worcester, MA)
- …& Grievances Coordinator serves to administer the FH Appeals and Grievance process as outlined in the Member Handbook/Evidence of Coverage, departmental policies ... appeals, which includes, educating the member and/or member representative about the grievance / appeal , gathering all pertinent and relevant information from the… more
- Commonwealth Care Alliance (Boston, MA)
- …pharmacy, dental, reporting, and member services. + Supports the Senior Appeals & Grievance Coordinator and A/G Coordinator in day-to-day tasks and ... Grievances & Appeals: + Responsible for the progress of grievance and appeal intervention and resolution. +...+ 0-2 years **Knowledge, Skills & Abilities (Required)** + Must be a self-starter with a high degree of… more
- State of Colorado (Jefferson County, CO)
- …for full consideration. Minimum Qualifications, Substitutions, Conditions of Employment & Appeal Rights Required Qualifications: + Must have completed either ... 101 and ECE 103 with no experience. All courses must be completed with a course grade of "C"...responsibility to coordinate its civil rights compliance activities and grievance procedures. For information, contact Executive Director of Human… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …drug policy, formulary availability, and specific coverage criteria. + Conducts first line appeal and grievance reviews for medical and pharmacy drugs in ... and training of new hire pharmacists. + Collaborates with Decision Criteria Coordinator to maintain and update decision criteria and denial language. + Research… more