- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Coordinator I (Temporary) Job Category: Customer Service Department: CSC Appeals & Grievances ... safety net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Coordinator I supports the Customer Solution… more
- Centene Corporation (Sacramento, CA)
- …and authorization appeals from providers and pursue resolution of formal grievances from members. + Gather, analyze and report verbal and written member and ... changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene...provider complaints, grievances and appeals + Prepare response letters… more
- Centene Corporation (Phoenix, AZ)
- …and authorization appeals from providers and pursue resolution of formal grievances from members. + Gather, analyze and report verbal and written member and ... changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene...provider complaints, grievances and appeals + Prepare response letters… more
- Commonwealth Care Alliance (Boston, MA)
- 011540 CCA- Appeals & Grievances **Position Summary** Appeals and Grievances Specialist supports the Operations Department and the Appeals and ... well as externally to facilitate timely resolution of all grievances and appeals and ensures compliance with...dental, reporting, and member services. + Supports the Senior Appeals & Grievance Coordinator and A/G … more
- Robert Half Accountemps (Los Angeles, CA)
- …guidelines for use by examiners or Participant Services Representatives. * Assist Appeals Coordinator with the preparation of Benefits Committee appeal cases. ... Strong knowledge of Basic Medical Terminology * Proven track record in handling Appeals and Medical Grievances * Excellent coordination and organization skills *… more
- CVS Health (Oklahoma City, OK)
- …every day. **Position Summary** Responsible for intake, investigation and resolution of appeals , complaints and grievances scenarios for all products, which may ... responses from multiple business units. Ensure timely, customer focused response to appeals , complaints and grievance. Identify trends and emerging issues and report… more
- Elevance Health (St. Petersburg, FL)
- …Law Enforcement). + Assists and participates in appeal or fair hearings, member grievances , appeals , and state audits. **Minimum Requirements:** + Requires BA/BS ... **LTSS Service Coordinator ** **Location** _:_ This is primarily a field...tools and pre-defined identification process, identifies members with potential clinical health care needs (including, but not limited to,… more
- Elevance Health (Mason, OH)
- …Law Enforcement). + Assists and participates in appeal or fair hearings, member grievances , appeals , and state audits. **Minimum Requirements:** + Requires BA/BS ... **LTSS Service Coordinator (Case Manager)** **Hiring statewide across Ohio** **Location**...tools and pre-defined identification process, identifies members with potential clinical health care needs (including, but not limited to,… more
- Elevance Health (Fresno, CA)
- …Law Enforcement). + Assists and participates in appeal or fair hearings, member grievances , appeals , and state audits. **Minimum Requirements:** + Requires BA/BS ... to client needs, and direct, hands-on engagement. The **LTSS Service Coordinator ** is responsible for conducting service coordination functions for a defined… more
- Highmark Health (Oklahoma City, OK)
- …through paid clams review. + Participate as pharmacy representative in onsite member appeals and grievances sessions. + Serve as a resource for technical ... obtain necessary and/or additional information when necessary. + Consult with staff clinical pharmacist for guidance and assistance as necessary. + Document all… more
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