, grievances and appeals Maintain files on individual appeals and grievances May coordinate the Grievance and Appeals Committee... and standards Education/Experience: High school diploma or equivalent. Associate’s degree preferred. 2+ years grievance...
supervision of a team of 4-6 appeals and grievance coordinators and is ultimately responsible for the work product of this team... and the Duals line of business. The Supervisor oversees all aspects of the Appeal and Grievance processes in accordance...
means to be part of Mass General Brigham. Job Summary The role is an integral part of our Appeals and Grievance review... collaborates with members of the Appeal and Grievance team, pharmacy team, and medical director teams to resolve all types...
appeal and grievance Policies and Procedures, workflows, Member correspondence, and training as needed, or on an annual basis.... Build and maintain strong working relationships with internal departments involved in appeal and grievance resolution...
issues. Prepare and analyze monthly appeal and grievance reports to meet internal and external reporting requirements...
Job Title Employee Disciplinary and Grievance Tech - BCSO Pay Rate United States of America (Hourly) Time Type Full... statistics on caseload information and develops complex reports Assists Grievance and Appeals Specialist and District Attorney...
subcontractors who have been delegated the responsibility for managing grievance and appeals on behalf of the plan, including... and data collection systems and prepares data reports and analysis of grievance and appeals for program management...
processing. This role does not perform grievance processing and is limited in scope to appeal-related tasks only. Interaction...
, Appeals & Grievance (A&G) Center of Quality & Excellence is a strategic leader responsible for driving operational performance..., regulatory compliance, service quality, and continuous improvement across all appeals and grievance functions. This position...
SUMMARY Under the general direction of the Member Appeals and Grievance Supervisor the Member Appeals and Grievance Analyst... appeals and grievance (complaints) received by Point32Health. This individual works collaboratively with the member and/or the...
Under the general direction of the Member Appeals and Grievance Supervisor the Appeals and Grievance Analyst is responsible... and grievance (complaints) received by Point32Health. This individual works collaboratively with the member and/or the member...
SUMMARY Under the general direction of the Member Appeals and Grievance Supervisor the Member Appeals and Grievance Analyst... appeals and grievance (complaints) received by Point32Health. This individual works collaboratively with the member and/or the...
SUMMARY Under the general direction of the Member Appeals and Grievance Supervisor the Member Appeals and Grievance Analyst... appeals and grievance (complaints) received by Point32Health. This individual works collaboratively with the member and/or the...
Under the general direction of the Member Appeals and Grievance Supervisor the Appeals and Grievance Analyst is responsible... and grievance (complaints) received by Point32Health. This individual works collaboratively with the member and/or the member...
Position Purpose: The Grievance Coordinator is responsible for managing, investigating, and resolving patient... to complainants in accordance with regulatory and internal standards. Track and maintain documentation of grievance cases in a secure...
what we do, as individuals and professionals, every day. The patient grievance coordinator ensures that the organization is in compliance...) standards in documentation and grievance follow-up. Serves as the lead person for the investigation, reporting, and resolution...
, and compassion - must guide what we do, as individuals and professionals, every day. The patient grievance coordinator ensures... Center for Medicare and Medicaid Services (CMS) standards in documentation and grievance follow-up. Serves as the lead person...
and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! Reporting to the Grievance... & Appeals Regulatory Manager, the Grievance & Appeals Regulatory Nurse is responsible for working directly with providers...
Under the general direction of the Member Appeals and Grievance Supervisor the Appeals and Grievance Analyst is responsible... and grievance (complaints) received by Point32Health. This individual works collaboratively with the member and/or the member...
Analytical thinker & Research Skills Grievance and Appeals experience. Experience in analyzing a claim Experience... in classification between a grievance/appeal/organizational determination. Education: Prefer a Bachelor's Degree EEO Employer...