• Lead Customer Solution Center

    LA Care Health Plan (Los Angeles, CA)
    Lead Customer Solution Center Appeals and Grievances Job Category: Administrative, HR, Business Professionals Department: CSC Appeals & Grievances ... to achieve that purpose. Job Summary The Lead of Customer Solution Center Appeals...solutions to handle irate members, and provide optimal customer service for internal and external customers. Must be… more
    LA Care Health Plan (12/19/24)
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  • Customer Solution Center

    LA Care Health Plan (Los Angeles, CA)
    Customer Solution Center Appeals and Grievances Specialist II Job Category: Administrative, HR, Business Professionals Department: CSC Appeals & ... to support the safety net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will… more
    LA Care Health Plan (02/07/25)
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  • Customer Solution Center

    LA Care Health Plan (Los Angeles, CA)
    Customer Solution Center Appeals and Grievances Nurse Specialist RN II Job Category: Clinical Department: CSC Appeals & Grievances Location: Los ... support the safety net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Nurse Specialist… more
    LA Care Health Plan (03/04/25)
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  • Appeals & Grievances Regulatory Audit…

    LA Care Health Plan (Los Angeles, CA)
    …and to support the safety net required to achieve that purpose. Job Summary The Customer Solution Center (CSC) Audit Readiness Specialist II is responsible ... end on all regulatory functions. Duties Audit readiness: Performs audit procedures for Customer Solution Center departments to ensure readiness; including… more
    LA Care Health Plan (02/02/25)
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  • Grievance and Appeals - Quality Analyst

    CVS Health (Columbus, OH)
    …care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just ... transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. **Position… more
    CVS Health (03/04/25)
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  • Business Analyst III

    LA Care Health Plan (Los Angeles, CA)
    …Preferred Required Training Physical Requirements Light Additional Information Department Specifics: Customer Solution Center Appeals and ... matter expertise in functional area to bridge business requirements and IT solutions ; provide technical direction and ensure compliance with best practice … more
    LA Care Health Plan (02/23/25)
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  • Supervisor, Complaint & Appeals

    CVS Health (Montgomery, AL)
    …care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just ... transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. **Position… more
    CVS Health (03/12/25)
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  • Customer Solution Center

    LA Care Health Plan (Los Angeles, CA)
    Customer Solution Center Quality Auditor II Job Category: Customer Service Department: Even MORE Quality Location: Los Angeles, CA, US, 90017 Position ... net required to achieve that purpose. Job Summary The Customer Solution Center Quality Auditor...Outreach, Ansafone, Web Inquiries, MRU (Member Relations Unit), and Appeals and Grievance, performance against key performance indicators and… more
    LA Care Health Plan (03/13/25)
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  • Customer Service Rep, Casualty

    Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
    …physicians, hospitals, and other healthcare providers with member benefits, eligibility, and appeals . The Customer Service Representatives must be able to work ... and communicate effectively with teams. + Transfer misdirected requests and offer solutions to non-routine issues. + Contribute to customer satisfaction and… more
    Brighton Health Plan Solutions, LLC (03/13/25)
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  • Customer Service Representative

    Brighton Health Plan Solutions, LLC (Melville, NY)
    … needs and concerns; demonstrate empathy and offer solutions . * Confirm customer understanding of the solution and provide additional customer education ... with member benefits, eligibility, claims inquiry, claim reconsiderations and appeals . This job description is not designed to cover...on ways to resolve problems to better serve the customer and/or improve productivity. * Offer solutions more
    Brighton Health Plan Solutions, LLC (01/03/25)
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