- Humana (Santa Fe, NM)
- …if you answered yes to any of the above you may be a great fit for Humana's Grievances & Appeals Representative 3 role! **What we need your help with:** + ... business needs** ** ** **but are always communicated ahead of the need.** ** Grievances and Appeals (G&A) has an impact to our business and because of the… more
- AmeriHealth Caritas (Philadelphia, PA)
- …more about us at www.amerihealthcaritas.com. **Responsibilities:** Reporting to the Supervisor, Appeals and Grievances , this position is responsible for the ... complaints/issues to management + Monitors to ensure that all problems with appeals / grievances presented by plan members/participants are resolved in accordance… more
- VNS Health (Manhattan, NY)
- …receipt. Prepares letters requesting Appointment of Representative (AOR) forms in grievances and appeals filed on behalf of member representatives. Prepares ... triage tasks, including intake, classification, setup, and assignment of grievances and appeals . Additionally, provides administrative support to… more
- Point32Health (TX)
- …responsible for the accurate coordination, efficient administration and resolution of member appeals and member grievances submitted by Point32Health members for ... + Must be able to organize, plan and implement the functions of Member Appeals and Grievances , maintain timelines and turnaround times to meet multiple… more
- Concentrix (Albuquerque, NM)
- …their insurance related needs. Examples include: Inquiries regarding benefits, eligibility, appeals , grievances and troubleshooting medical devices. All while ... Job Title: Customer Service Representative (Healthcare) - Remote Job Description The Customer... (Healthcare) - Remote Job Description The Customer Service Representative (Remote) works from home and interfaces with customers… more
- CVS Health (Atlanta, GA)
- …claim hand-offs, and escalates issues as appropriate through the system for grievances and appeals . * Initiates out-reach/welcome calls to ensure constituents ... expectations are met or exceeded. Identifies trends and any emerging customer service issues and works to develop solutions to address potential problems and/or plan features of interest as an approach to improve understanding of benefit plans and increase… more
- CVS Health (Sacramento, CA)
- …claim hand-offs, and escalates issues as appropriate through the system for grievances and appeals . Initiates out-reach/welcome calls to ensure constituents ... expectations are met or exceeded. Identifies trends and any emerging customer service issues and works to develop solutions to address potential problems and/or plan features of interest as an approach to improve understanding of benefit plans and increase… more
- City of New York (New York, NY)
- …jurisdiction of the Department of Correction" - Investigate serious incidents - Review grievances from people in custody and staff - Evaluate the performance of the ... perform other duties as determined by the General Counsel. Appeals Under the Board's Minimum Standards, whenever DOC decides...requirement applies to you, please discuss with the agency representative at the time of interview. WORK LOCATION: 2… more
- State of Colorado (CO)
- …employment laws, progressive discipline, records management, recruitment, responding to grievances , appeals , charges of discrimination, reorganization matters, ... retention, selection and selection appeals , worker's compensation, settlement advice, strategic planning and overall...+ Promotes positive morale within the section. Addresses employee grievances and complaints in a timely and effective manner.… more
- State of Colorado (Golden, CO)
- …development training (as available) + Resolves informal staff grievances . Provide formal/informal performance feedback. Initiate progressive discipline, in ... for all youth + Responds to and resolves youth grievances + Act as first public contact with agency...the official appeal form, signed by you or your representative . This form must be delivered to the State… more