APPEALS AND GRIEVANCES COORDINATOR jobs in UNITED STATES, United Kingdom

grievances, appeals, and interprets and explains health plan benefits, policies, and procedures to Medi-Cal enrollees. The ​Medi...-Cal Appeals and Grievance Coordinator​ will report to the ​Operations Supervisor. In this role you will​ be responsible...

grievances, appeals, and interprets and explains health plan benefits, policies, and procedures to Medi-Cal enrollees. The ​Medi...-Cal Appeals and Grievance Coordinator​ will report to the ​Operations Supervisor. In this role you will​ be responsible...

and family, dental and vision, plans for employers, etc. Title: Grievance & Appeals Coordinator Work Location: Detroit, MI... will be responsible for analyzing, researching, resolving, and responding to complaints, appeals, and grievances from Client members...

Primary Responsibilities The Appeals & Grievance Coordinator is accountable for managing and processing all Medicare... reconsiderations, grievances, provider disputes and appeals, in accordance with company policy and the Centers for Medicare...

or serve as Project Coordinator as needed for QUEST Integration Administration Activities for grievances and appeals... inquires, complex complaints, grievances and appeals relating to all aspects of health plan coverage consistent with contract...

The Customer Solution Center Appeals and Grievances Coordinator I supports the Customer Solution Center Appeals... decisions, assists the Customer Solution Center Appeals & Grievance Manager and Director in meeting regulatory timelines...

SUMMARY: The Grievance Coordinator is responsible for timely intake, processing, researching, documenting..., and responding to grievances referred to Alivi by health plan partners. Responsible for entering pertinent information into the...

and grievances process, and compiling reports for analysis purposes. The Grievance and Appeals Coordinator will also present cases... this need could evolved based on business needs). The Appeals and Grievance Coordinator will coordinate, process, and document...

and grievances process, and compiling reports for analysis purposes. The Grievance and Appeals Coordinator will also present cases... this need could evolved based on business needs). The Appeals and Grievance Coordinator will coordinate, process, and document...

for intake, investigation and resolution of appeals, complaints and grievances scenarios for all products, which may contain... response to appeals, complaints and grievance. Identify trends and emerging issues and report and recommend solutions...

for intake, investigation and resolution of appeals, complaints and grievances scenarios for all products, which may contain... response to appeals, complaints and grievance. Identify trends and emerging issues and report and recommend solutions...

complaints, grievances and appeals Prepare response letters for member and provider complaints, grievances and appeals Maintain... files on individual appeals and grievances May coordinate the Grievance and Appeals Committee Support the pay...

grievance/appeals from providers and members. Resolve all State inquires related to complaints, grievances and appeals.... Review and process member and provider grievances and appeals within federal, state and organizational regulations...

Quality Improvement - Grievance & Appeals Coordinator 195-1007 Tulsa, OK, USA Req #566 Monday, June 17, 2024... JOB SUMMARY: Responsible for all written inquiries from members seeking resolution through the grievance and appeals process...

member/subscriber grievances, appeals, and interprets and explains health plan benefits, policies, and procedures to Medi-Cal... enrollees. The ​Medi-Cal Appeals and Grievance Coordinator​ will report to the ​Operations Supervisor. In this role...

member/subscriber grievances, appeals, and interprets and explains health plan benefits, policies, and procedures to Medi-Cal... enrollees. The ​Medi-Cal Appeals and Grievance Coordinator​ will report to the ​Operations Supervisor. In this role...

, and much more. The Clinical Appeals and Grievance Coordinator (RN) is an integral part of our Appeals and Grievance review process.... Under the direction of the Director of Appeals and Grievances, this clinician will ensure clinical/pharmacy appeal cases reviews...