- Elevance Health (Olathe, KS)
- ** Provider Grievance and Appeals - Business Change Advisor** **Location: Topeka KS, or Olathe, KS** This position will work a hybrid model (remote and ... of one of our Kansas Elevance Health PulsePoint locations. The ** Provider Grievance and Appeals - Business Change Advisor** is responsible for… more
- Banner Health (AZ)
- …employment settings by including remote and hybrid opportunities. In the role of Senior Grievance & Appeals Coordinator, you will utilize your expertise in ... Grievance & Appeals and Medicare to oversee diverse tasks and responsibilities,...by which each employee is to handle member and provider grievances, appeals and claim disputes. This… more
- Banner Health (AZ)
- …settings by including remote and hybrid opportunities. In the role of Health Plans Grievance and Appeals Coordinator, you will be an integral member of our ... reducing costs. POSITION SUMMARY This position handles member and provider grievances, standard appeals and claim disputes....concerns and inquiries on the various levels of the grievance and appeals process. CORE FUNCTIONS 1.… more
- Elevance Health (Los Angeles, CA)
- **Title: Grievance / Appeals Analyst I** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of ... one of our PulsePoint locations. The ** Grievance / Appeals Analyst I** is an entry level position in the Enterprise Grievance & Appeals Department that… more
- Elevance Health (Richmond, VA)
- …grievances and appeals requests in the Enterprise Grievance & Appeals Department from customer types (ie member, provider , regulatory, and third party) ... **Title: Grievance / Appeals Analyst II** **Location:** This position...clinical information. + Identify opportunities for improvement and any provide support and assistance to G & A Analyst… more
- Elevance Health (Los Angeles, CA)
- **Manager II Grievance / Appeals - Claims Support** This position will work in a hybrid model (remote and office). Ideal candidates will live within 50 miles of ... one of our PulsePoint locations. The **Manager II Grievance / Appeals ** is responsible for management oversight of grievances and appeals departmental units to… more
- Elevance Health (Indianapolis, IN)
- **Title: Grievance / Appeals Representative I** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 ... miles of one of our PulsePoint locations. The ** Grievance / Appeals Representative I** is responsible for reviewing, analyzing and processing claims in accordance… more
- Centers Plan for Healthy Living (Margate, FL)
- RN - Grievance and Appeals Clinical Reviewer 5297 W Copans Rd, Margate, FL 33063, USA Req #461 Monday, September 9, 2024 Centers Plan for Healthy Living's goal ... the guidance and plans they need for healthy living. JOB SUMMARY: The Grievance & Appeal Clinical Reviewer performs complex medical necessity reviewed on Initial… more
- Henry Ford Health System (Troy, MI)
- …prompt and thorough investigation of medical, transportation, and pharmacy member appeals and grievances for Health Alliance Plan's (HAP's): Commercial, Medicare ... Advantage, Medicare-Medicaid Program (MMP), and Medicaid lines of business . Analyst must identify trending issues on an ongoing basis and provide root/cause… more
- Elevance Health (Atlanta, GA)
- **Manager I - Grievances & Appeals - Provider Disputes** **Location** : This position will work a hybrid model (in office 1-2 days per week). The ideal candidate ... for the management oversight of receipt, investigation and processing associated with member/ provider grievances and appeals . **How you will make an impact:**… more