Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve member and provider complaints... and appeals exercising strong independent judgment. This position will provide resolution of complaints in compliance with Centers...
Center Appeals and Grievances Coordinator I supports the Customer Solution Center Appeals & Grievance Specialists by handling... Solution Center Appeals & Grievance Manager and Director in meeting regulatory timelines by maintaining an accurate database...
, in a consistent and accurate manner. This position will focus on quality review of non-clinical grievance and appeals cases... by the Management Team. Duties Focus on quality review of grievance and appeals cases for all LOB to identify areas...
Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve member and provider complaints... and appeals exercising strong independent judgment. This position will provide resolution of complaints in compliance with Centers...
Immediate need for a talented Grievance and Appeals. This is a 06+months contract to Hire opportunity with long-term... the Grievance and Appeals Committee Support the pay-for-performance programs, including data entry, tracking, organizing...
care eligibility, access, grievance and appeals issues, preferably in health services, legal services and/or public... Solution Center Appeals and Grievances is responsible for the centralized intake, logging and triage process for all member...
Center Appeals and Grievances Specialist I primary function is to learn the specialty level appeals and grievances work... supporting the higher level position in this class series to ensure positive outcomes for members. It will support the Appeals...
all due dates for each file. Inform nurses of a new case received from Grievance and Appeals Specialist.; submit..., retrospective reviews, concurrent reviews and grievance/appeal requests, and prepares UM Activity and Weekly Compliance Reports...
all due dates for each file. Inform nurses of a new case received from Grievance and Appeals Specialist.; submit..., retrospective reviews, concurrent reviews and grievance/appeal requests, and prepares UM Activity and Weekly Compliance Reports...