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Complaints Grievances And Appeals Jobs

Visiting Nurse Service of New York (VNSNY) is the nation’s largest not-for-profit community-based health system. VNSNY provides a comprehensive array of home- and community-based programs, including health plans, tailored to the needs of high-risk, vulnerable New...
JOB SUMMARY: The C&G/Appeals Supervisor is responsible for overseeing the Complaints and Grievances/Appeal Specialists to ensure compliance with client regulatory...
The Complaints and Grievances Specialist is responsible to coordinate resolution for Member and Provider Complaints/Appeals/Grievances/Fair Hearings. This is done by...
Responds to written/verbal grievances, complaints, appeals and disputes submitted by members and providers in accordance with NCQA, CMS, NY State and other regulations. Types...
Avesis Incorporated Position Overview This position is located in the Operations Department of Avesis operational headquarters in Phoenix, Arizona. Required duties include...
Position Overview This position is located in the Operations Department of Avesis operational headquarters in Phoenix, Arizona. The duties of the Appeals & Grievance...
POSITION SUMMARY This person is the subject matter expert and independently coaches others on complaints and appeals ensuring compliance with Federal and/or State...
ABOUT OUR COMPANY ValueOptions is a health improvement company that serves more than 32 million individuals. On behalf of employers, health plans and government agencies, we...
Physicians United Plan (PUP) is a Medicare Advantage Coordinated Healthcare Plan that also provides Prescription Drug Coverage for its members. PUP is contracted with the...
Candidates are required to have experience working with complaints, appeals, and grievances. POSITION SUMMARY Responsible for the day-to-day management of staff to ensure...
The Complaints and Grievances Specialist is responsible to coordinate resolution for Member and Provider Complaints/Appeals/Grievances/Fair Hearings. This is done by...
Position Description: Positions in this function are responsible for reviewing, researching, investigating, and triaging all types of appeals and grievances. Communicates...
UnitedHealthcare Military & Veterans (UHC M&V) is part of the family of companies that make UnitedHealth Group one of the leaders across the US health care system.We serve...
Join the Medicare Team at Network Health as a full time, Medicare Member Advocate! Enjoy a generous benefit plan including the choice of two health insurance plans with an outstanding wellness program, short and long term disability at no cost and education reimbursement...
Position Summary / Key Job Responsibilities: The Labor Relations Manager will interpret and administer labor agreements covering approximately 350 represented employees. Duties will include processing of grievances, drafting local agreements, interpretation of negotiated...
Medix Staffing Solutions is seeking a Customer Service Representative to work with a National Health Care Insurance Company in Phoenix, AZ! Please apply today if you meet the...
About Fallon Community Health Plan: Founded in 1977, Fallon Community Health Plan is a nationally recognized, not-for-profit health care services organization. From...
JOB VACANCY NOTICE JOB NUMBER: 14-033- 2645 CLOSING DATE: April 25, 2014 - 1:00 p.m. CST STARTING SALARY RANGE: $46,136 $51,903 annually, plus excellent benefits POSITION...
Customer Service Representative / CSR / Call Center Opportunities: Medix Staffing Solutions is seeking Customer Service Representatives / CSR's to work with a National Health...
Principal Accountabilities: Provides written acknowledgement of all provider initiated correspondence. Conducts thorough investigations of all provider correspondence by...
JOB SUMMARY: This position is responsible for the coordination of audits and reports for Complaints and Grievances. This includes responsibility for preparation, quality...
Primary Purpose: Provide in-house legal support services to the superintendent, designated staff, and board of trustees. Advise the superintendent and board in legal...