- US Tech Solutions (Canton, MA)
- **Job Description:** + Under the general direction of the Member Appeals and Grievance Supervisor the Member Appeals and Grievance Analyst is ... for the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by company. + This individual… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor , Customer Solution Center Appeals and Grievances Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, ... to support the safety net required to achieve that purpose. Job Summary The Supervisor , Customer Solution Center Appeals & Grievances is responsible for direct… more
- Corewell Health (Grand Rapids, MI)
- …SITE - Priority Health - 1239 E Beltline - Grand Rapids Department Name PH - Grievance And Appeals Medicare Employment Type Full time Shift Day (United States of ... basis. Ensure CMS, decisions are properly implemented. Assist the Lead, Supervisor and/or Manager in coordinating activities and in the development/collection of… 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 Angeles, CA, US, ... required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve member… more
- Centene Corporation (Austin, TX)
- …state, federal and accrediting body requirements. + Provide supervision for appeals and grievance , quality of care/service; provider redeterminations and ... respond to complex quality of care or quality of service, appeal and grievance or provider redetermination inquiries. + Coordinate with management to ensure the… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor , Authorization Technician Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... the safety net required to achieve that purpose. Job Summary The Supervisor , Authorization Technician supports the Utilization Management (UM) Specialist by handling… more
- The Cigna Group (Nashville, TN)
- …related issues, implications and decisions. The Case Management Analyst reports to the Supervisor /Manager of Appeals and will coordinate and perform all appeal ... **Cigna Medicare Part C Appeals Reviewer: Appeals Processing Analyst** We...Director. + Determine whether additional pre service, appeal or grievance reviews are required and/or whether additional appeal rights… more
- Missouri State University (Springfield, MO)
- …contrast to Administrative Assistants who provide administrative support services to a supervisor or for the department as a whole. The Administrative Specialist II ... and use of University assets, issue permits, process parking tickets and appeals , etc. Description of Primary Duties The Administrative Specialist II works in… more
- Independent Health (Buffalo, NY)
- …ICD-9-CM, ICD-10-CM and HCPCS coding preferred. + Experience in Compliance regulations, appeals and grievance knowledge preferred. + Demonstrated ability to ... Respectful, Trustworthy, Collaborative and Accountable. **Essential Accountabilities** Servicing and Grievance Appeal Team: + Research and respond to escalated and… more
- Missouri State University (Springfield, MO)
- …contrast to Administrative Assistants who provide administrative support services to a supervisor or for the department as a whole. The Administrative Specialist II ... and use of University assets, issue permits, process parking tickets and appeals , etc. Description of Primary Duties This position will be responsible for… more
- MTA (New York, NY)
- …and participate in monthly conferences with union representatives to discuss contract grievance and employee discipline appeals ; perform analytical review of ... $100,000 HAY POINTS : 551 DEPT/DIV : Labor Relations SUPERVISOR : Assistant Director, Labor Relations LOCATION : 420...sanctioned by the National Mediation Board for all contract grievance and employee discipline cases. + Provide leadership and… more
- State of Colorado (Adams County, CO)
- …team meetings in collaboration with CYSO III + Ensure that youth grievance policy and procedure are followed. Review of grievances to include investigation, ... are applying. Incomplete employer information (address, phone number, and supervisor ) or omission of former employers may result in...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (Denver, CO)
- …youth, in accordance with the living unit master schedule, shift supervisor and/or other administrative direction. Provide corrective cognitive, emotional or ... team meetings in collaboration with CYSO III + Ensure that youth grievance policy and procedure are followed. Review of grievances to include investigation,… more
- State of Colorado (Golden, CO)
- …team meetings in collaboration with CYSO III + Ensure that youth grievance policy and procedure are followed. Review of grievances to include investigation, ... are applying. Incomplete employer information (address, phone number, and supervisor ) or omission of former employers may result in...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (Greeley, CO)
- …team meetings in collaboration with CYSO III + Ensure that youth grievance policy and procedure are followed. Review of grievances to include investigation, ... are applying. Incomplete employer information (address, phone number, and supervisor ) or omission of former employers may result in...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- City of Lakeland (Lakeland, FL)
- …claims processing and represents the City of Lakeland in unemployment claims and appeals hearings, securing the participation of the HR Director and HR counsel for ... Skill in establishing and maintaining effective, professional working relationships with supervisor , co-workers, employees, and the general public. + Ability to… more
- CDS Life Transitions (Webster, NY)
- …in at least one of the following areas: call center operations, MLTC, grievance and appeals , and/or authorizations. The listed salary range represents the ... timeframes, and proper procedures, ensuring errors are identified and corrected. Keeps supervisor apprised of any concerns or errors. + Document complaints in the… more
- MTA (New York, NY)
- …SALARY RANGE: $98,742 - $107,375 HAY POINTS: 611 DEPT/DIV: Labor Relations SUPERVISOR : Senior Director, Administrative Trails & Hearings LOCATION: 2 Broadway HOURS ... labor relations issues such as contract interpretation, disciplinary matter, medical appeals , Civil Service Law and matters affecting Authority-wide policy and… more