Grievance/Appeals Representative II
4 weeks ago
Grievance/Appeals Representative II Location: Hybrid 500 Unicorn Park Drive Woburn, MA The Grievance/Appeals Representative II is responsible for reviewing, analyzing and processing policies related to claims events to determine the extent of the company's liability and entitlement. How you will make an impact: Conducts investigation and review of customer grievances and appeals involving provision of service and benefit coverage issues. Contacts customers to gather information and communicate disposition of case; documents interactions. Generates written correspondence to customers such as members, providers and regulatory agencies. Researches administrative or non-clinical aspects of the appeal, e.g. eligibility, benefit levels, overall adherence to policies and practices. May make decision on administrative appeals where guidelines are well documented and involve limited discretion. Prepares files for internal or external review by analysts, medical staff or outside consultant. Triages clinical and non-clinical inquiries, grievances and appeals, prepares case files for member grievance committees/hearings. Summarizes and presents essential information for the clinical specialist or medical director and legal counsel. Minimum Requirements: Requires a HS diploma or equivalent and a minimum of 2 years experience in customer service, preferably in a managed care environment, medical office, or health insurance; or any combination of education and experience which would provide an equivalent background. Preferred Skills, Capabilities and Experiences: Ability to organize work, set and manage multiple priorities in a time sensitive manner is strongly preferred. Good oral and written communication skills, basic word processing, data base management, spreadsheet skills, PC proficiency and claims knowledge strongly preferred.
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Grievance/appeals Representative Ii
1 month ago
Woburn, United States Elevance Health Full timeJob Family: CLM > Claims Support - Type: Full time - Date Posted: Apr 24, 2024 - Anticipated End Date: May 23, 2024 - Reference: JR110934 **Description**: **Grievance/Appeals Representative II** **Location**:Hybrid 500 Unicorn Park Drive Woburn, MA The **Grievance/Appeals Representative II **is responsible for reviewing, analyzing and processing policies...
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Customer Service Representative Ii Phones
7 days ago
Woburn, United States SaviLinx Full time**JOB TITLE: Customer Service Representative II Phones ($16/hr + $1/pay for performance)** **DEPARTMENT**:Operations **REPORTS TO**:Supervisor **FLSA STATUS**: Non-Exempt **OUR GUIDING PRINCIPLES**: Make every interaction Count Act with Respect and Integrity Demonstrate Passion for Continuous Improvement Be Worth of Trust from all...
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Medical Assistant
5 days ago
woburn, United States Cambridge Health Alliance Full timep>Location: CHA Cambridge Hospital Work Days: M-F, Some evenings Category: Medical Assistant Department: Pediatric Office Practice Cambridge Job Type: Full time Work Shift: Various Shifts Hours/Week: 40.00 Union: Yes Union Name: CH Laborers 380 Cambridge Health Alliance (CHA) is a leader in Primary Care, supporting a highly diverse...
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Pricing Specialist Ii Ma
20 hours ago
Woburn, United States Beacon Building Products Full timeOverview: Joining Beacon Building Products as a **Pricing Specialist II **means becoming part of a values-driven organization. Our core principles guide everything we do: putting people first, prioritizing safety, doing what's right, taking pride in our work, continuously improving, and making significant strides towards a more sustainable future. Be part...
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Cook II-Full Service Restaurant 1
6 days ago
Woburn, United States Hilton Boston Woburn Full timeJob Summary: The Cook II is responsible for supervising and assisting in the preparation of all food items for the Restaurant/Dining Outlet Cafe Room Service Employee Cafeteria and Banquets while maintaining the highest standards to produce an appealing and appetizing product. Responsibilities: QUALIFICATIONS: Previous supervisory responsibility preferred....
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Cook II-Full Service Restaurant 1
22 hours ago
Woburn, United States Hilton Boston Woburn Full timeJob Summary: The Cook II is responsible for supervising and assisting in the preparation of all food items for the Restaurant/Dining Outlet Cafe Room Service Employee Cafeteria and Banquets while maintaining the highest standards to produce an appealing and appetizing product. Responsibilities: QUALIFICATIONS: Previous supervisory responsibility preferred....
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Medical Equipment Service Technician II
1 week ago
Woburn, United States Steris Corporation Full timeAt STERIS, we help our Customers create a healthier and safer world by providing innovative healthcare and life science product and service solutions around the globe. Position Summary Are you mechanically inclined with a knack for hands-on work? Do you enjoy a flexible schedule and working independently, but also have the support of a team? The Equipment...
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Medical Equipment Service Technician II
23 hours ago
Woburn, United States Steris Corporation Full timeAt STERIS, we help our Customers create a healthier and safer world by providing innovative healthcare and life science product and service solutions around the globe. Position Summary Are you mechanically inclined with a knack for hands-on work? Do you enjoy a flexible schedule and working independently, but also have the support of a team? The Equipment...
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Universal Banker II
1 week ago
Woburn, United States SFB Full timeHIRING BONUS: This position is eligible for a $2,500 hiring bonus for new hires only. Speak with a Human Resources representative for more information. Salem Five is a growing regional financial services organization with a rich history of over 160 years. As an independent bank, we are deeply rooted in the communities we serve and offer our employees...
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Welding and Container Shop Manager
1 week ago
Woburn, United States Waste Management Full timeAs an EEO/Affirmative Action Employer, all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, age, national origin, disability, or veteran status. I. Job SummaryManages the day-to-day operations of the container shop including inventory, repairs, deliveries and...
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Welding and Container Shop Manager
20 hours ago
Woburn, United States Waste Management Full timeAs an EEO/Affirmative Action Employer, all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, age, national origin, disability, or veteran status. I. Job SummaryManages the day-to-day operations of the container shop including inventory, repairs, deliveries and...
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Welding and Container Shop Manager
7 days ago
Woburn, United States Waste Management Full timeAs an EEO/Affirmative Action Employer, all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, age, national origin, disability, or veteran status. I. Job SummaryManages the day-to-day operations of the container shop including inventory, repairs, deliveries and...
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Welding and Container Shop Manager
5 days ago
Woburn, United States Waste Management Full timeAs an EEO/Affirmative Action Employer, all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, age, national origin, disability, or veteran status. I. Job SummaryManages the day-to-day operations of the container shop including inventory, repairs, deliveries and...
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Welding and Container Shop Manager
1 week ago
Woburn, United States Waste Management Full timeAs an EEO/Affirmative Action Employer, all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, age, national origin, disability, or veteran status. I. Job SummaryManages the day-to-day operations of the container shop including inventory, repairs, deliveries and...
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Welding and Container Shop Manager
1 day ago
Woburn, United States Waste Management Full timeAs an EEO/Affirmative Action Employer, all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, age, national origin, disability, or veteran status. I. Job SummaryManages the day-to-day operations of the container shop including inventory, repairs, deliveries and...
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Restaurant Director-full Service Restaurant 1
19 hours ago
Woburn, United States Hilton Boston Woburn Full timeJob Summary: The Restaurant Director is responsible for assuring attentive friendly courteous and efficient service in the F&B Outlets while maintaining adherence to budgeted payroll and overhead cost. He/she is also responsible for continually working towards improving the Outlets sales revenues to meet or exceed budget. The Restaurant Director is...
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Welding and Container Shop Manager
6 days ago
Woburn, United States Waste Management Full timeJob DescriptionAs an EEO/Affirmative Action Employer, all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, age, national origin, disability, or veteran status.I. Job SummaryManages the day-to-day operations of the container shop including inventory, repairs,...
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Specimen Collector
1 week ago
Woburn, United States Disa Global Solutions Full timeDISA Global Solutions is an industry-leading safety and compliance solutions provider with customers across the Globe since 1986 and more than 1,200+ Team members across more than 30 locations. When you join the DISA Team, you join an industry leader that more than 30% of fortune 500 companies use. With a rich history of IT innovation, we have more than...
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Specimen Collector
23 hours ago
Woburn, United States Disa Global Solutions Full timeDISA Global Solutions is an industry-leading safety and compliance solutions provider with customers across the Globe since 1986 and more than 1,200+ Team members across more than 30 locations. When you join the DISA Team, you join an industry leader that more than 30% of fortune 500 companies use. With a rich history of IT innovation, we have more than...
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IV Compounding Pharmacy Tech
1 week ago
Woburn, United States B. Braun Medical Inc. Full timeOverview CAPS, the nation's largest network of outsourcing admixture pharmacies, has been delivering high-quality, same-day, admixture services and solutions to hospitals and outpatient facilities for more than 28 years. Along with the nation's largest 503A sterile injectable outsourcing network, CAPS offers industry-leading batch compounding on a national...