Grievance & Appeals Specialist

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 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 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...

Appeals and Grievances SupervisorOur client in Downtown Los Angeles is seeking an Appeals and Grievances Supervisor to join their team in a mostly remote role with occasional on-site work.Key Responsibilities:Supervise and support a team handling appeals and grievances, ensuring thorough investigations and timely resolutions.Lead and direct team work,...

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 organized and detail-oriented Grievance and Appeals Coordinator to join our team at MedPOINT Management.The successful candidate will be responsible for handling appeals and grievances, researching cases, and resolving issues in a timely and efficient manner.Key ResponsibilitiesHandle appeals and grievances by inputting...

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 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, monitoring research and resolution of appeals and grievances, and 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 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 Title: Appeals and Grievances SupervisorThe Appeals and Grievances Supervisor plays a critical role in ensuring the efficient and effective resolution of appeals and grievances within the healthcare industry. This position requires a strong leader who can supervise and support a team of professionals in handling complex cases, analyzing data, and...

Job Title: Customer Solutions Center Appeals and Grievances Training Specialist IIThis role is responsible for designing and delivering training programs to enhance the skills and knowledge of the Customer Solutions Center Appeals and Grievances team.Key Responsibilities:Develop and implement training strategies to improve employee performance and...

Job DescriptionJob Title: Customer Solutions Center Appeals and Grievances Training Specialist IIJob Type: Hybrid | PermanentLocation: Los Angeles, CA (Position will be Hybrid - will be conducting combination WebEx and in near future Onsite Trainings)Required Skills:3 years experience in Healthcare Industry3 years experience designing and conducting...

Job Title: Customer Solutions Center Appeals and Grievances Training Specialist IIAt CCG Business Solutions, LLC, we are seeking a highly skilled and experienced Training Specialist II to join our team. As a key member of our Customer Solutions Center Appeals and Grievances team, you will be responsible for providing ongoing training on the core processing...

Job Summary:The Customer Solutions Center Appeals and Grievances (A&G) Training Specialist II is a key role in the department, responsible for designing and conducting training programs using established regulatory and departmental guidelines. This position provides ongoing training on the core processing system, A&G processing procedures, and regulatory...

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 Title: Customer Solutions Center Appeals and Grievances Training Specialist IIThe Customer Solutions Center Appeals and Grievances Training Specialist II is a key member of our team, responsible for providing ongoing training on the core processing system, A&G processing procedures, and regulatory changes that impact established procedures. This role...

Job DescriptionWe are seeking a detail-oriented Medicare Claims Appeals Specialist with a comprehensive understanding of Medicare claims processing, including provider contracts, Division of Financial Risk (DOFR), explanation of benefits, and claim edits.Key Responsibilities:Review and process Medicare provider appeals cases for California clients, adhering...