- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist III Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los ... and to support the safety net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Specialist III will… more
- 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 ... 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
- CVS Health (Columbus, OH)
- …are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital ... matter and independently coaches others on matters regarding complaints and appeals , ensuring compliance with federal and/or state regulations. Ensures compliance… more
- 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 (Los Angeles, CA)
- Customer Solution Center Audit Readiness Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, ... net required to achieve that purpose. Job Summary The Customer Solution Center (CSC) Audit...minimum of 5 years of experience in regulatory auditing ( Appeals & Grievances, Call Center , Enrollment) in… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …physicians, hospitals, and other healthcare providers with member benefits, eligibility, and appeals . The Customer Service Representatives must be able to work ... and communicate effectively with teams. + Transfer misdirected requests and offer solutions to non-routine issues. + Contribute to customer satisfaction and… more
- 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
- 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
- State of Colorado (Lakewood, CO)
- …employees. Our culture has public service focus, and we strive to provide innovative solutions and services to our fellow Coloradans! Careers with a purpose: If you ... the numerous criminal justice computer systems, to include the Colorado Crime Information Center (CCC) and the National Crime Information Center (NCIC) computer… more
- 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
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