Senior Grievance Resolution Specialist

About the RoleWe are seeking a highly skilled Grievance & Appeals Specialist to join our team at EmblemHealth. As a key member of our organization, you will be responsible for responding to written and verbal grievances, complaints, and appeals submitted by members and providers in accordance with NCQA, CMS, State, and other regulations.Key...

Job Title: Case Manager Associate - Grievance Resolution SpecialistAt Elevate, we are seeking a highly motivated and detail-oriented Case Manager Associate to join our Advisory Americas team. As a key member of our team, you will play a critical role in supporting the development and growth of our grievance mechanism solutions and products.Key...

Job SummaryWe are seeking a highly skilled Grievance and Appeals Specialist to join our team at EmblemHealth. As a key member of our organization, you will be responsible for responding to written and verbal grievances, complaints, appeals, and disputes submitted by members and providers in accordance with regulatory requirements.Key...

About the RoleWe are seeking a skilled Appeals and Grievances Specialist I to join our team at Solugenix Corporation. This is a 6-month contract opportunity based out of Los Angeles, CA (Remote).Key ResponsibilitiesMaintain the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting...

Job OverviewVillageCare MAX seeks a highly skilled Supervisor of Grievances and Appeals to oversee the investigation and resolution of complaints and grievances from members.This role is responsible for managing all aspects of the grievance system, ensuring compliance with DOH and CMS requirements, and working to investigate and process grievances in a...

Job OverviewPosition: Supervisor of Grievance & AppealsCompany: VillageCare MAXThe Supervisor of Grievances and Appeals is responsible for overseeing the investigation and resolution of member complaints and grievances. This role involves managing all facets of the grievance system processes in alignment with regulatory requirements, ensuring that grievances...

About the Role:The Appeals and Grievances Specialist I will be responsible for maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting noncompliance, and adhering to company policy and procedures, including accreditation requirements, and applicable federal, state and...

Position SummaryThe Senior Counsel, Corporate Transactions, will join a small legal team at a rapidly growing company. The Senior Counsel provides legal advice for Resolution Life US's complex insurance growth and other transactions, manages corporate governance activities for Resolution Life US, and provides support for other areas, as needed, within the...

Company Overview: At Utica National Insurance Group, our corporate promise is to make people feel secure, appreciated, and respected. With 1,400 employees countrywide, we strive to deliver exceptional service and build strong relationships with our customers.Salary: The salary for this role is estimated to be between $80,000 and $120,000 per year, based on...

Job SummaryWe are seeking a highly skilled Chargeback Associate Senior to join our team at FIS - Fidelity Information Services. As a key member of our dispute resolution team, you will be responsible for reviewing, researching, and initiating the resolution of dispute inquiries from cardholders, financial institutions, merchants, and internal departments.Key...

Job SummaryWe are seeking a highly skilled Chargeback Associate Senior to join our team at FIS - Fidelity Information Services. As a key member of our dispute resolution team, you will be responsible for reviewing, researching, and initiating the resolution of dispute inquiries from cardholders, financial institutions, merchants, and internal departments.Key...

Job Title: Medicare Claims Appeals SpecialistJob Summary:The Medicare Claims Appeals Specialist is responsible for reviewing and resolving member and provider complaints, and communicating resolutions to members and providers in accordance with standards and requirements established by the Centers for Medicare and Medicaid Services (CMS).Key...

Job SummaryThe City of New York is seeking a highly skilled and dedicated Customer Resolution Specialist to join our team. As a key member of our Family Independence Administration, you will be responsible for addressing and resolving various inquiries and complaints related to Cash and Emergency Assistance, Supplemental Nutrition Assistance Program, and...

Job SummaryWe are seeking a highly skilled and experienced Senior Dental Network Operations Specialist to join our team at EmblemHealth. This is a critical role that requires a strong understanding of the healthcare industry, dental provider credentialing, and claims systems.Key ResponsibilitiesManage the administration, monitoring, and oversight of...

Job Title: Claims SpecialistAt Selby Jennings, we are seeking a highly skilled Claims Specialist to join our team. As a Claims Specialist, you will be responsible for overseeing complex and high-exposure claims, executing coverage verification, claim investigation, reserving, and disposition.Key Responsibilities:Claim Oversight: Manage and oversee the most...

Job OpportunityAre you a motivated and results-driven individual looking for a challenging role in debt settlement? National Debt Cure is seeking a skilled Debt Specialist to join our team.Key Responsibilities:Acquire new customers through prospecting efforts and inbound inquiriesEngage existing customers through various channels to provide exceptional...

About the RoleWe are seeking a highly skilled and detail-oriented Grievances and Appeals Representative to join our team at Humana. As a key member of our healthcare services team, you will play a critical role in ensuring that our members receive the best possible care and support.Key ResponsibilitiesConduct comprehensive analytic reviews of clinical...

Job SummaryWe are seeking a highly skilled and motivated Customer Resolution Representative to join our team at the City of New York. As a key member of our Family Independence Administration, you will play a critical role in addressing and resolving various inquiries and complaints related to Cash and Emergency Assistance, Supplemental Nutrition Assistance...

About the RoleThe American Society of Composers, Authors and Publishers (ASCAP) is seeking a highly skilled Licensing Resolution Manager to join our team. As a key member of our Broadcast Licensing department, you will be responsible for managing an ongoing Salesforce database of music users across multiple lines of business that are not in good standing...

Job Summary: We are seeking a highly skilled Human Resources Specialist 3 Labor Relations to join our team at the New York State Civil Service. As a key member of our HR department, you will provide expert advice and support on labor relations matters, including negotiated agreements, conflict resolution, and employee relations.Key Responsibilities:Provide...