• QA Auditor : Appeals

    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
    Healthfirst (03/11/25)
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  • Appeals and Grievances

    Point32Health (MA)
    …Summary** Under the direction of the A&G Manager, the Appeals & Grievances QA Auditor audits the quality of letters and keyed entries from the ... audit findings and identifies areas of opportunity for the A&G ( Appeals and Grievances ) department. Understands department, segment, organizational strategy… more
    Point32Health (03/08/25)
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