• Appeals Specialist I ( Remote

    CareFirst (Baltimore, MD)
    **Resp & Qualifications** **PURPOSE:** The Appeals Specialist I is responsible for the initial analysis of appeals and/or grievance correspondence, and ... breaching confidentiality of medical information. + Assists Supervisor and Appeals Specialist II and III with unit...with unit projects and other duties related to the appeals , grievance , and/or reconsideration process. Communicates with… more
    CareFirst (12/12/25)
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  • Customer Solution Center Appeals

    LA Care Health Plan (Los Angeles, CA)
    Customer Solution Center Appeals and Grievances Specialist II (Temporary) Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los ... net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve… more
    LA Care Health Plan (11/06/25)
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  • Senior RN Peer Review Specialist

    Blue Cross Blue Shield of Massachusetts (Boston, MA)
    …and Management Team + Legal Department: + Medical Directors + Member Appeals Grievance Programs (Commercial, Medicare Advantage, and InterPlan Program) + ... healthcare? Bring your true colors to blue. The Role:The Peer Review Specialist is responsible for monitoring the quality of the credentialed practitioner/… more
    Blue Cross Blue Shield of Massachusetts (12/06/25)
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