• Specialist , Appeals…

    Molina Healthcare (Omaha, NE)
    …+ Responsible for the comprehensive research and resolution of the appeals , dispute, grievances , and/or complaints from Molina members, providers ... that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance outcomes. +… more
    Molina Healthcare (06/26/25)
    - Related Jobs

  • 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 ... required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve… more
    LA Care Health Plan (07/08/25)
    - Related Jobs

  • 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 ... as well as externally to facilitate timely resolution of all grievances and appeals and ensures compliance with regulations. Additionally, this position is… more
    Commonwealth Care Alliance (05/21/25)
    - Related Jobs

  • Appeals and Grievances Program…

    Commonwealth Care Alliance (Boston, MA)
    011540 CCA- Appeals & Grievances **Position Summary:** Appeals and Grievances Program Advisor monitors and supports the operations and compliance of the ... Appeals and Grievances department through many NCQA...+ Communicate and work collaboratively with AG Representatives, Resolution Specialist and Management to maintain and improve quality of… more
    Commonwealth Care Alliance (06/06/25)
    - Related Jobs

  • Appeals Specialist II, (Remote)

    CareFirst (Baltimore, MD)
    **Resp & Qualifications** **PURPOSE:** The Appeals Specialist II will be responsible for the initial analysis of appeals /grievance correspondence, and ... collecting, organizing and tracking information to facilitate and expedite processing of appeals / grievances received from a variety of sources. Responsible for… more
    CareFirst (07/30/25)
    - Related Jobs

  • Appeals Specialist I (remote)

    CareFirst (Baltimore, MD)
    **Resp & Qualifications** **PURPOSE:** The Appeals Specialist I is responsible for the initial analysis of appeals and/or grievance correspondence, and ... and tracking information to facilitate and expedite processing of appeals and/or grievances received from a variety...breaching confidentiality of medical information. + Assists Supervisor and Appeals Specialist II and III with unit… more
    CareFirst (07/30/25)
    - Related Jobs

  • Grievance & Appeals Specialist

    Robert Half Accountemps (Los Angeles, CA)
    …A Medical IPA Group in Los Angeles is in the immediate need of a Grievance & Appeals Specialist . The Grievance & Appeals Specialist , will be in ... with State/Federal laws, rules, and guidelines. The Grievance & Appeals Specialist will be expected to perform...Basic Medical Terminology * Proven track record in handling Appeals and Medical Grievances * Excellent coordination… more
    Robert Half Accountemps (07/20/25)
    - Related Jobs

  • Customer Solution Center Audit Readiness…

    LA Care Health Plan (Los Angeles, CA)
    …Center Audit Readiness Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position Type: ... call documentation and categorization, service authorization request and coverage determination , Appeals and Grievances across all lines of business). This… more
    LA Care Health Plan (07/17/25)
    - Related Jobs

  • Disability/Elder Benefit Specialist (HHS)

    Walworth County (Elkhorn, WI)
    …contact, in home or community Provide information on consumer rights, complaints, grievances and appeals processes and assistance in preparing and filing ... Disability/Elder Benefit Specialist (HHS) Print (https://www.governmentjobs.com/careers/walworthco/jobs/newprint/5021485) Apply  Disability/Elder Benefit...complaints, grievances and appeals at the local, state… more
    Walworth County (07/25/25)
    - Related Jobs

  • CDOC - Human Resources Specialist V (Human…

    State of Colorado (CO)
    CDOC - Human Resources Specialist V (Human Resources Manager) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4994350) Apply  CDOC - Human ... Resources Specialist V (Human Resources Manager) Salary $7,610.00 - $12,177.00...develop performance plans and sign performance documents; resolve informal grievances ; provide coaching, mentoring, approve leave, manage workloads; +… more
    State of Colorado (07/22/25)
    - Related Jobs