Appeals & Grievances Nurse

As the Appeals & Grievances Nurse, you will play a key role in managing and resolving New Century Health Plan member appeals and grievances. You will: Ensuring timely, accurate, and thorough review of member and provider complaints, working closely w Appeals, Nurse, Healthcare

Job DescriptionDescriptionAs the Appeals & Grievances Nurse, you will play a key role in managing and resolving New Century Health Plan member appeals and grievances. You will: Ensuring timely, accurate, and thorough review of member and provider complaints, working closely with clinical and administrative teams.Assessing cases to determine the...

One of our top clients in Downtown Los Angeles is looking for an Appeals & Grievances Supervisor to join their team mostly remote (on-site 2 days/month expected)!Required Skills and Experience: 3+ years’ experience in a healthcare setting in Grievances and Appeals, Compliance, Claims or Call Center.2+ years’ experience leading process, program, or staff...

One of our top clients in Downtown Los Angeles is looking for an Appeals & Grievances Supervisor to join their team mostly remote (on-site 2 days/month expected)!Required Skills and Experience: 3+ years’ experience in a healthcare setting in Grievances and Appeals, Compliance, Claims or Call Center.2+ years’ experience leading process, program, or staff...

One of our top clients in Downtown Los Angeles is looking for an Appeals & Grievances Supervisor to join their team mostly remote (on-site 2 days/month expected)!Required Skills and Experience: 3+ years’ experience in a healthcare setting in Grievances and Appeals, Compliance, Claims or Call Center.2+ years’ experience leading process, program, or staff...

Job SummaryThe Appeals and Grievances Supervisor is responsible for leading a team that handles appeals and grievances in the healthcare industry. This role involves supervising and supporting team members, monitoring research and resolution of appeals and grievances, and ensuring thorough investigations are completed according to company policies and...

Job Title: Appeals and Grievances SupervisorThe Appeals and Grievances Supervisor plays a critical role in ensuring the efficient resolution of appeals and grievances within the Customer Solution Center. This position involves leading a team of professionals who handle the intake, research, resolution, tracking, and reporting of appeals and grievances.Key...

Job SummaryThe Appeals and Grievances Supervisor is responsible for leading a team that handles appeals and grievances in a healthcare setting. This role involves supervising and supporting team members in researching, negotiating, and resolving appeals and grievances, ensuring thorough investigations are completed according to company policies and...

Job SummaryThe Appeals and Grievances Supervisor is responsible for leading a team that handles appeals and grievances in a healthcare setting. This role involves supervising and supporting team members, monitoring research and resolution of appeals and grievances, and ensuring thorough investigations are completed according to company policies and...

Job Summary: We are seeking a highly skilled Appeals and Grievances Specialist II to join our team at Insight Global. As a key member of our Appeals and Grievances team, you will play a critical role in receiving, investigating, and resolving member and provider complaints and appeals.Key Responsibilities:Support the Appeals and Grievances team in receiving,...

Job SummaryThe Appeals and Grievances Specialist I will support the Appeals and Grievances team in receiving, investigating, and resolving member and provider complaints and appeals. This role will escalate complex issues or questions to leadership as appropriate.Key ResponsibilitiesLearn the specialty level appeals and grievances work by resolving less...

Job SummaryWe are seeking a highly organized and detail-oriented Appeals and Grievances Specialist II to join our team at Insight Global. As a key member of our Appeals and Grievances team, you will be responsible for receiving, investigating, and resolving member and provider complaints and appeals in a timely and efficient manner.Key...

Job SummaryWe are seeking a highly skilled Appeals and Grievances Specialist I to join our team at Insight Global. As a key member of our Customer Solution Center, you will play a critical role in receiving, investigating, and resolving member and provider complaints and appeals.Key ResponsibilitiesInvestigate and resolve less complex appeals and grievances...

Job SummaryWe are seeking a highly motivated and detail-oriented Appeals and Grievances Specialist I to join our team at Insight Global. As a key member of our Appeals and Grievances team, you will play a critical role in supporting the investigation and resolution of member and provider complaints and appeals.Key ResponsibilitiesInvestigate and resolve less...

Job Summary The Customer Solution Center Appeals and Grievances Nurse Specialist LVN II is primarily responsible for the overall coordination of the Appeals & Grievance (A&G) program for L.A. Care Health Plan members under the direct supervision and management of the A&G Nurse Specialist, RN and/or Medical Director. This position provides assistance to...

Supervisor, Appeals and Grievances Clinical Operations RN Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 11617 Salary Range: $102,183.00 (Min.) - $132,838.00 (Mid.) - $163,492.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency...

Job Summary:Manager II Grievance/Appeals is responsible for management oversight of grievances and appeals departmental units to investigate, resolve, and respond to client/provider grievances/appeals and ensure compliance with regulatory requirements.Key Responsibilities:Maintains and coordinates staff activities to achieve departmental and corporate goals...

Job DescriptionAppleOne is seeking a highly skilled Grievance & Appeals Specialist to join our team. As a key player in the healthcare sector, this role will involve processing intakes, acknowledging complaints, and preparing case files for investigation and resolution. The ideal candidate will have strong independent judgment and be able to escalate complex...

Customer Solution Center Appeals and Grievances Specialist II Job Category: Customer Service Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 11505 Salary Range: $60,778.00 (Min.) - $75,950.00 (Mid.) - $91,166.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California...

Customer Solution Center Appeals and Grievances Specialist II Job Category: Customer Service Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 11145 Salary Range: $60,778.00 (Min.) - $75,950.00 (Mid.) - $91,166.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California...