- Fallon Health (Worcester, MA)
- …applicable regulatory requirements and member expectations. The FH Member Appeals and Grievance Intake Administrator serves to administer the FH ... Appeals and Grievance process as outlined in the FH ...Coverage, departmental policies and procedures, and regulatory standards. The Member Appeals & Grievances Intake … more
- VNS Health (Manhattan, NY)
- … review processes within Appeals & Grievances Department. + Manages the intake , investigation and resolution of member grievances and appeals for ... the complexities of healthcare? VNS Health Plans is seeking a dedicated Manager, Grievance and Appeals (RN)to lead the daily operations of our grievance and … more
- VNS Health (Manhattan, NY)
- … intake , classification, setup, and assignment of grievances and appeals . Additionally, provides administrative support to staff, including tasks such as ... Do + Identifies case types (eg- clinical vs non-clinical appeals ) during the intake process, communicates and...procedures. Maintains confidentiality of information. + Maintains knowledge of Grievance and Appeals (G&A) procedures, and CMS… more
- Baylor Scott & White Health (Temple, TX)
- **JOB SUMMARY** The Appeals and Grievance Coordinator is responsible for intake into the Appeals and Grievances Department, including verbal and written ... OF THE ROLE** + Intakes and processes written and fax referred cases from member and provider appeals and complaints for all lines of business, ensuring… more
- CVS Health (Oklahoma City, OK)
- …-Identify and research all components within member or provider/practitioner appeals , complaints and grievance for all products and services. -Triage ... heart, each and every day. **Position Summary** Responsible for intake , investigation and resolution of appeals , complaints...of all components of appeals , complaints and grievance including final communication to member /provider for… more
- CareOregon (Portland, OR)
- …and grievances provisions and process to members, providers and CareOregon staff. + Perform intake of member and provider appeals & reconsiderations, gather ... appeals and notify members and providers of outcome. + Assist the Appeals & Grievance Coordinators, Pharmacists, Medical Directors and Quality Improvement… more
- Utica University (Utica, NY)
- …Enough laws. + Serve as an intermediary for parties involved throughout formal grievance process (eg, complaint intake , investigation, evidence and report view, ... IX Coordinators, Responsible Administrators, investigators, decision makers and persons hearing appeals on relevant topics relating to their associated roles in… more
- Utica College (Utica, NY)
- …Enough laws. + Serve as an intermediary for parties involved throughout formal grievance process (eg, complaint intake , investigation, evidence and report view, ... IX Coordinators, Responsible Administrators, investigators, decision makers and persons hearing appeals on relevant topics relating to their associated roles in… more
- LA Care Health Plan (Los Angeles, CA)
- …and Outreach, Ansafone, Web Inquiries, MRU ( Member Relations Unit), and Appeals and Grievance , performance against key performance indicators and recognizes ... were met across all verticals under CSC. Conducts random member audits and surveys to ensure the member...is also responsible for assisting Call Center with call intake as needed. (10%) Performs other duties as assigned.… more