• Customer Solution Center

    LA Care Health Plan (Los Angeles, CA)
    Customer Solution Center Appeals and Grievances Specialist I Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los ... to support the safety net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Specialist I primary function… more
    LA Care Health Plan (04/28/25)
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  • Customer Solution Center

    LA Care Health Plan (Los Angeles, CA)
    Customer Solution Center Appeals and Grievances Specialist II (ALD) Job Category: Customer Service Department: CSC Appeals & Grievances Location: ... to support the safety net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will… more
    LA Care Health Plan (05/15/25)
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  • Appeals & Grievances Regulatory Audit…

    LA Care Health Plan (Los Angeles, CA)
    …and to support the safety net required to achieve that purpose. Job Summary The Customer Solution Center (CSC) Audit Readiness Specialist II is responsible ... end on all regulatory functions. Duties Audit readiness: Performs audit procedures for Customer Solution Center departments to ensure readiness; including… more
    LA Care Health Plan (05/04/25)
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  • Business Analyst III

    LA Care Health Plan (Los Angeles, CA)
    …Preferred Required Training Physical Requirements Light Additional Information Department Specifics: Customer Solution Center Appeals and ... matter expertise in functional area to bridge business requirements and IT solutions ; provide technical direction and ensure compliance with best practice … more
    LA Care Health Plan (05/14/25)
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  • Patient Account Representative - Panama City…

    Surgery Care Affiliates (Panama City, FL)
    …Health is redefining specialty care by developing more accessible, patient-centered practice solutions for a network of more than 370 ambulatory surgical centers, ... accurate, professional responses and resolution. The PAR will function within the Center 's policies and procedures, support SCA Values, SCA Vision and SCA Mission.… more
    Surgery Care Affiliates (05/09/25)
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  • Prior Authorization Specialist

    US Tech Solutions (RI)
    …inquiries to the pharmacist team as appropriate. **Experience:** + 0-3 years in a customer service or call center environment managing 75 calls/day. + Six months ... and/or resolve coverage requests. + Escalate issues to Coverage Determinations and Appeals Learning Advocates and management team as needed. + Must maintain… more
    US Tech Solutions (05/08/25)
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  • Senior Patient Accounts Processor

    Whitney Young Health Center (Albany, NY)
    …payers via phone or website, contacting practices, navigating cross-departmentally, writing appeals and facilitating their direction to Athena CBO for submission, ... required by WYH for employment purposes and co-pays when appropriate. + Develops solutions to claim processing and payer adjudication problems. + Learn and keep up… more
    Whitney Young Health Center (05/17/25)
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  • Customer Service Representative

    CVS Health (Springfield, IL)
    …every day. **Position Summary** We are currently recruiting top talent for our Center of Excellence Customer Service group. Responsibilities below include, but ... about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our...response to inquiries received. **Required Qualifications** -1 year of Customer service in a call center environment… more
    CVS Health (05/17/25)
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  • Representative I

    US Tech Solutions (May, OK)
    …of relevant and changing Med D guidance **Experience:** + 2-3 years in a customer service or call center environment managing 75 calls/day. + Six months ... and/or resolve coverage requests. + Escalate issues to Coverage Determinations and Appeals Learning Advocates and management team as needed. + Must always maintain… more
    US Tech Solutions (05/07/25)
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  • Customer Service New Business Operations-…

    CVS Health (Franklin, TN)
    …are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital ... the member to the fullest to champion for our members' best health. + Anticipates customer needs. + Provides the customer with related information to answer the… more
    CVS Health (05/11/25)
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