Current jobs related to Grievance and appeals coordinator - Woodland Hills - Randstad
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Woodland Hills, United States Blue Shield of California Full timeYour Role The Medicare Appeals and Grievances Non-Clinical team receives, documents, investigates, refers, and coordinates grievances, appeals and complaints. The Appeals and Grievances Representative, Specialist will report to the Operations Supervisor. In this role you will be responsible for oversight of team reviewing, researching, and responding to...
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Woodland Hills, United States Blue Shield of California Full timeYour Role The Medicare Appeals and Grievances Non-Clinical team receives, documents, investigates, refers, and coordinates grievances, appeals and complaints. The Appeals and Grievances Representative, Specialist will report to the Operations Supervisor. In this role you will be responsible for oversight of team reviewing, researching, and responding to...
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Woodland Hills, United States Blue Shield of California Full timeYour Role The Medicare Appeals and Grievances Non-Clinical team receives, documents, investigates, refers, and coordinates grievances, appeals and complaints. The Appeals and Grievances Representative, Specialist will report to the Operations Supervisor. In this role you will be responsible for oversight of team reviewing, researching, and responding to...
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Woodland Hills, United States Blue Shield of California Full timeYour Role The Medicare Appeals and Grievances Non-Clinical team receives, documents, investigates, refers, and coordinates grievances, appeals and complaints. The Appeals and Grievances Representative, Specialist will report to the Operations Supervisor. In this role you will be responsible for oversight of team reviewing, researching, and responding to...
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United States, CA, Woodland Hills Blue Shield of California Full timeYour Role The Medicare Appeals and Grievances Non-Clinical team receives, documents, investigates, refers, and coordinates grievances, appeals and complaints. The Appeals and Grievances Representative, Specialist will report to the Operations Supervisor. In this role you will be responsible for oversight of team reviewing, researching, and responding to...
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Appeals and Grievances Specialist
1 week ago
El Dorado Hills, California, United States Blue Shield of California Full timeAbout the RoleThe Appeals and Grievances team at Blue Shield of California is seeking a highly skilled and experienced professional to join our team as an Appeals and Grievances Representative, Advanced. In this role, you will be responsible for handling incoming appeals and grievances, researching and resolving complex issues, and providing exceptional...
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Appeals and Grievances Specialist
1 week ago
El Dorado Hills, California, United States Blue Shield of California Full time{"Your Role": "As a key member of the Appeals and Grievances team at Blue Shield of California, you will play a critical role in ensuring that our members receive fair and timely resolutions to their appeals and grievances.", "Responsibilities": "Key responsibilities of this role include:Responding to incoming appeals and grievances in a timely and...
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Appeals and Grievances Representative, Advanced
4 weeks ago
El Dorado Hills, United States Blue Shield of California Full timeYour Role The Appeals and Grievances team receives, documents, investigates, refers, and coordinates grievances, appeals and complaints. The Appeals and Grievances, Advanced Coordinator will report to the Appeals and Grievances Supervisor. In this role you will be responsible for taking incoming telephone calls, reviewing, researching, and responding to...
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Appeals and Grievances Representative, Advanced
4 weeks ago
El Dorado Hills, United States Blue Shield of California Full timeYour Role The Appeals and Grievances team receives, documents, investigates, refers, and coordinates grievances, appeals and complaints. The Appeals and Grievances, Advanced Coordinator will report to the Appeals and Grievances Supervisor. In this role you will be responsible for taking incoming telephone calls, reviewing, researching, and responding to...
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Appeals and Grievances Representative, Advanced
4 weeks ago
El Dorado Hills, United States Blue Shield of California Full timeYour Role The Appeals and Grievances team receives, documents, investigates, refers, and coordinates grievances, appeals and complaints. The Appeals and Grievances, Advanced Coordinator will report to the Appeals and Grievances Supervisor. In this role you will be responsible for taking incoming telephone calls, reviewing, researching, and responding to...
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Appeals and Grievances Representative, Advanced
4 weeks ago
El Dorado Hills, United States Blue Shield of California Full timeYour Role The Appeals and Grievances team receives, documents, investigates, refers, and coordinates grievances, appeals and complaints. The Appeals and Grievances, Advanced Coordinator will report to the Appeals and Grievances Supervisor. In this role you will be responsible for taking incoming telephone calls, reviewing, researching, and responding to...
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Appeals and Grievances Representative, Advanced
3 weeks ago
El Dorado Hills, United States Blue Shield of California Full timeYour RoleThe Appeals and Grievances team receives, documents, investigates, refers, and coordinates grievances, appeals and complaints. The Appeals and Grievances, Advanced Coordinator will report to the Appeals and Grievances Supervisor. In this role you will be responsible for taking incoming telephone calls, reviewing, researching, and responding to...
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Appeals and Grievances Representative, Advanced
4 weeks ago
El Dorado Hills, CA, United States Blue Shield of California Full timeYour Role The Appeals and Grievances team receives, documents, investigates, refers, and coordinates grievances, appeals and complaints. The Appeals and Grievances, Advanced Coordinator will report to the Appeals and Grievances Supervisor. In this role you will be responsible for taking incoming telephone calls, reviewing, researching, and responding to...
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El Dorado Hills, United States Blue Shield of CA Full timeYour Role The Blue Shield Promise Medi-Cal Appeals and Grievance team researches and resolves 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 you will be responsible for...
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Appeals and Grievances Representative, Advanced
4 weeks ago
United States, CA, El Dorado Hills Blue Shield of California Full timeYour Role The Appeals and Grievances team receives, documents, investigates, refers, and coordinates grievances, appeals and complaints. The Appeals and Grievances, Advanced Coordinator will report to the Appeals and Grievances Supervisor. In this role you will be responsible for taking incoming telephone calls, reviewing, researching, and responding to...
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Appeals and Grievances Representative, Advanced
3 weeks ago
El Dorado Hills, CA, United States Blue Shield of California Full timeYour Role The Appeals and Grievances team receives, documents, investigates, refers, and coordinates grievances, appeals and complaints. The Appeals and Grievances, Advanced Coordinator will report to the Appeals and Grievances Supervisor. In this role you will be responsible for taking incoming telephone calls, reviewing, researching, and responding to...
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Operations Manager
1 week ago
Woodland Hills, California, United States Blue Shield Of California Full time{"title": "Operations Manager", "content": "Job SummaryBlue Shield of California is seeking an experienced Operations Manager to join our Appeals and Grievances team. As a key member of our leadership team, you will be responsible for leading a team of professionals in resolving member concerns through a regulated process.Key ResponsibilitiesLead a team of...
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Manager, Operations
4 weeks ago
Woodland Hills, United States Blue Shield of California Full timeYour Role The Appeals and Grievances team is responsible for resolving our members concerns through a regulated process which includes accurately, timely and compliantly addressing each of the members concerns. The Operations, Manager will report to the Senior Director of Operations. In this role you will In this role you will provide leadership and...
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Experienced Operations Coordinator
4 weeks ago
El Dorado Hills, California, United States Blue Shield Of California Full timeYour RoleThe Commercial Appeals and Grievances team conducts thorough investigations concerning the details and situations surrounding member complaints, appeals, and grievances. The Operations Specialist - Experienced will report to a Supervisor within the Commercial Appeals and Grievances department. In this capacity, you will collaborate with the...
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Operations Director
1 week ago
Woodland Hills, California, United States Blue Shield of California Full time{"h1": "Operations Manager Role at Blue Shield of California", "p": "As a key member of our Appeals and Grievances team, you will play a critical role in resolving member concerns through a regulated process. Your expertise will ensure accurate, timely, and compliant addressing of each concern. You will report to the Senior Director of Operations and provide...
Grievance and appeals coordinator
4 months ago
A trusted client of Randstad's has openings for experienced Grievance and Appeals Coordinators. Must be experienced with grievance and appeals, claim denials, medical terminology and CPT codes. Previous Grievance and Appeals experience preferred. Ability to communicate with providers and members is essential. If interested, please apply with an updated resume.salary: $19.99 - $22 per hourshift: Firstwork hours: 8 AM - 6 PMeducation: High SchoolResponsibilities Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members. Gather, analyze and report verbal and written member and provider 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-for-performance programs, including data entry, tracking, organizing, and researching information Assist with HEDIS production functions including data entry, calls to provider's offices, and claims research. Manage large volumes of documents including copying, faxing and scanning incoming mailSkillsClaim DenialsCPT CodesQualificationsYears of experience: 1 yearExperience level: ExperiencedRandstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact HRsupport@randstadusa.com.Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including health, an incentive and recognition program, and 401K contribution (all benefits are based on eligibility).Applications accepted on ongoing basis until filled.Qualified applicants in San Francisco with criminal histories will be considered for employment in accordance with the San Francisco Fair Chance Ordinance. We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance.
