- Centene Corporation (Phoenix, AZ)
- … and Appeals Committee + Support the pay-for-performance programs, including data entry , tracking, organizing, and researching information + Assist with ... and appeals + Maintain files on individual appeals and grievances + May coordinate the Grievance...HEDIS production functions including data entry , calls to provider's offices, and… more
- CareFirst (Baltimore, MD)
- …and reconsiderations. Prioritize, research, analyze, and perform accurate data entry for more complex grievances, appeals , and reconsiderations including ... II will be responsible for the initial analysis of appeals / grievance correspondence, and determination of next steps,...in monthly meetings and discussions regarding quality appeal and/or grievance research, data entry and… more
- CareFirst (Baltimore, MD)
- …processes. Actively participates in monthly meetings and discussions regarding quality appeal and/or grievance research, data entry and to problem solve any ... Specialist I is responsible for the initial analysis of appeals and/or grievance correspondence, and determination of...Access the appropriate database to implement accurate and timely entry of a grievance , appeal and/or reconsideration… more
- CareFirst (Baltimore, MD)
- …and processes. Actively participates in monthly meetings and discussions regarding quality appeal and grievance research, data entry and to problem solve any ... Specialist I is responsible for the initial analysis of appeals and/or grievance correspondence, and determination of...issues regarding the appeal and/or grievance intake/ entry process. **QUALIFICATIONS:** **Education Level:** High… more
- Point32Health (MA)
- …providers. + Identifies issues with casework, including, but not limited to data entry errors within system, incorrect processes followed, untimely processing, ... QA Auditor audits the quality of letters and keyed entries from the Grievance and Appeals systems. Checks cases built by other associates to ensure highest level… more
- LA Care Health Plan (Los Angeles, CA)
- …and Member or Provider Appeals , including, but not limited to computer data entry , logging, copying, preparing of template letters for communication of ... and Weekly Compliance Reports. In addition, the position performs data entry and processing of referrals/authorizations in...file. Inform nurses of a new case received from Grievance and Appeals Specialist.; submit all Grievances… more
- Roper St. Francis (Charleston, SC)
- …to include coordinating with outside attorneys and claim adjustors, providing support and data entry in litigation matters, respond to inquiries from RSFH staff ... to include coordinating with outside attorneys and claim adjustors, providing support and data entry in litigation matters, respond to inquiries from RSFH staff… more
- State of Colorado (Denver, CO)
- …treatment standards and clinical pathways; + Position ensures that computer data entry , referrals and consultations, medical reporting, medical co-signature ... and inmate grievance requirements are completed in accordance with DOC Administrative...of the department's action. For more information about the appeals process, the official appeal form, and how to… more