- Point32Health (MA)
- …communities. **Job Summary** Under the direction of the A&G Manager, the Appeals & Grievances QA Auditor audits the quality of letters and keyed entries ... audit findings and identifies areas of opportunity for the A&G ( Appeals and Grievances ) department. Understands department, segment, organizational strategy… more
- Healthfirst (NY)
- …and Responsibilities:** + Conduct quality audits of A&G items including grievances , pre-service appeals , and post service appeals utilizing appropriate ... to reduce errors and improve processes and performance to ensure quality . + Review and investigate appeals and grievances requests to ensure all requests are… more
- LA Care Health Plan (Los Angeles, CA)
- …is the liaison in external and or (CMS) claim audits Organization Determination, Appeals & Grievances (ODAG) of delegates and subsequently monitors delegates ... Specialty Health Plans Claims Auditor III Job Category: Accounting/Finance Department: Financial Compliance...Mission: LA Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and… more
- City of Columbus (Columbus, OH)
- …the City's labor relations unit on matters such as collective bargaining, grievances , arbitrations and mediations, disciplinary actions and appeals , etc.; ... changes, disciplinary actions, and certification of payroll adjustment to the Auditor 's Office; Oversees the administration of employee benefits to include… more
- Dignity Health (Bakersfield, CA)
- …manner to the health plan. - Partners as needed with the appeals and grievances functions of the department. **Qualifications** **Minimum Qualifications:** ... health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups hospitals… more