• Associate Specialist

    Molina Healthcare (Austin, TX)
    …and prepare responses to appeals and grievances . + Elevates appropriate appeals to the Appeals Specialist . + Generates and mails denial letters. ... systems and other available resources. + Assures timeliness and appropriateness of appeals according to state and federal and Molina Healthcare guidelines. +… more
    Molina Healthcare (08/30/25)
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  • Customer Solution Center Appeals

    LA Care Health Plan (Los Angeles, CA)
    Customer Solution Center Appeals and Grievances Quality Auditing Specialist II Job Category: Administrative, HR, Business Professionals Department: CSC ... Summary The Customer Solution Center Appeals and Grievances Quality Auditing (QA) Specialist II is...Perform other duties as assigned. Duties Continued Education Required Associate 's Degree In lieu of degree, equivalent education and/or… more
    LA Care Health Plan (08/29/25)
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  • Customer Solution Center Appeals

    LA Care Health Plan (Los Angeles, CA)
    Customer Solution Center Appeals and Grievances Specialist I (Temporary) Job Category: Customer Service Department: CSC Appeals & Grievances ... achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Specialist I...High School Diploma/or High School Equivalency Certificate Education Preferred Associate 's Degree Experience Required: At least 1 year of… more
    LA Care Health Plan (09/05/25)
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  • Customer Solution Center Appeals

    LA Care Health Plan (Los Angeles, CA)
    Customer Solution Center Appeals and Grievances Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los ... safety net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate… more
    LA Care Health Plan (09/03/25)
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  • Appeals and Grievances Program…

    Commonwealth Care Alliance (Boston, MA)
    …accuracy. **Required Education:** + Associate 's Degree or equivalent experience in Appeals and Grievances **Desired Education:** + Bachelor's Degree (BS or ... 011540 CCA- Appeals & Grievances **Position Summary:** ...+ Communicate and work collaboratively with AG Representatives, Resolution Specialist and Management to maintain and improve quality of… more
    Commonwealth Care Alliance (09/05/25)
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  • Appeals and Grievance Specialist

    Commonwealth Care Alliance (Boston, MA)
    011540 CCA- Appeals & Grievances **Position Summary** Appeals and Grievances Specialist supports the Operations Department and the Appeals and ... Alliance (CCA) as well as externally to facilitate timely resolution of all grievances and appeals and ensures compliance with regulations. Additionally, this… more
    Commonwealth Care Alliance (08/20/25)
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  • Medicare/Medicaid Claims Reimbursement…

    Commonwealth Care Alliance (Boston, MA)
    …schedule issues. + Collaborate closely with Provider Relations, Contracting, Payment Integrity, Appeals & Grievances , and Configuration teams to validate and ... Education (must have):** + N/A **Desired Education (nice to have):** + Associate 's or Bachelor's degree in Health Administration, Finance, or related field… more
    Commonwealth Care Alliance (08/31/25)
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  • People Relations Partner Associate III

    Volunteers of America Los Angeles (Los Angeles, CA)
    …and resolution of facts and issues in matters affecting disciplinary actions, grievances , appeals , and complaints, refers complex matters to HR Employee ... People Relations Partner Associate III Location:Los Angeles, CA Job ID:4053 Salary:$80116.92...Relations Specialist or Senior Manager of Employee Relations as required… more
    Volunteers of America Los Angeles (08/29/25)
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