Hybrid Customer Solution Center Appeals and Grievances Training Specialist II

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 DescriptionThe Customer Solutions Center Appeals and Grievances (A&G) Training Specialist II is responsible for providing ongoing training on the core processing system, A&G processing procedures, training regulatory changes which will affect established procedures, working with the quality team on quality and performance guidelines, creating 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 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 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 SummaryThe Customer Solution Center Appeals and Grievances Specialist II plays a critical role in ensuring the highest level of service to our members and providers. This position is responsible for receiving, investigating, and resolving member and provider complaints and appeals, exercising strong independent judgment.This role requires a deep...

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...

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...

Job SummaryThe Regulatory Compliance Specialist II is responsible for ensuring the Customer Solution Center (CSC) is ready for regulatory audits. This position will develop a successful auditing strategy for end-to-end processes within CSC, including enrollment processing, timeliness and accuracy of loading members, and outbound health risk assessment calls....

Job Title: Information Technology Specialist IThe Office of Tax Appeals is seeking a highly skilled Salesforce developer to join our team as an Information Technology Specialist I. As a key member of our IT department, you will be responsible for analyzing our case management processes and ensuring that our Salesforce workflows meet the business needs of our...

Job Title: Loan Specialist IILocation: Grand Ave., Los Angeles, CA 90071 (Hybrid three times a week in office.)Job Type: ContractCompensation: $30-$Work Requirements: US Citizen, GC Holders or Authorized to Work in the USWe are seeking a skilled Loan Specialist II to join our team at INSPYR Solutions. As a Loan Specialist II, you will be responsible for...

About Specialist DirectWe are a leading telehealth company specializing in organ transplant services. Our cloud-based diagnostic solutions have improved organ utilization and increased placements nationwide.The RoleAs our Client Support Manager, you will oversee our 24/7 Client Support team, ensuring seamless client interactions and efficient workflow...

Job Title: GIS Specialist IIJob Summary:CMTS is seeking a highly motivated GIS Specialist II to join our team in Los Angeles, CA. As a GIS Specialist II, you will be responsible for developing and supporting LAWA's ArcGIS Indoors information model for wayfinding and space planning.Key Responsibilities:* Develop and maintain web and mobile geospatial...

Job SummaryCordoba Corporation is seeking a highly skilled GIS Specialist II to support our Facilities Sector. As a key member of our team, you will play a crucial role in planning and designing capital investments, including airfield improvements, terminal improvements, infrastructure improvements, and more.You will develop and support the client's ArcGIS...

Job SummaryThe Clinical Operations Supervisor RN is responsible for overseeing the day-to-day clinical operations of the Appeals and Grievances department. This includes ensuring proper staffing and coverage, monitoring and evaluating departmental operations, and documenting and addressing any deviations in work or organizational expectations.This role...

Job Title: Loan Specialist IIJob Summary:As a Loan Specialist II at INSPYR Solutions, you will play a crucial role in processing commercial and retail loans, preparing approval or closing documents, and ensuring accuracy and completeness of loan files. You will work under direct supervision, utilizing your knowledge and skills gained through on-the-job...

Job SummaryWe are seeking a highly skilled Medicaid Specialist to join our team at Phang Staffing Solution. As a Medicaid Specialist, you will play a critical role in helping underserved seniors access essential care and support through Medicaid and Medicare applications.Key ResponsibilitiesInitiate, assist, and manage Medicaid applications for prospective...

Job Summary: As a Loan Specialist II at INSPYR Solutions, you will play a crucial role in processing commercial and retail loans, preparing approval or closing documents, and ensuring compliance with all state and federal regulations. This position requires strong analytical and problem-solving skills, as well as the ability to work independently and...

Job Summary:As a skilled Nurse Care Specialist with vTech Solution, you will provide high-quality patient care in a dynamic and supportive environment. Your expertise will be utilized to deliver exceptional healthcare services, ensuring the well-being of our patients.Responsibilities:- Provide direct patient care, including administering medications, wound...

Job Title:Product Solutions Manager IIJob Summary:The Product Solutions Manager II is a key member of the Product Strategy, Sales and Marketing (PSSM) service area, responsible for identifying and implementing projects, programs, and initiatives that support the achievement of product and enterprise goals.Key Responsibilities:Develops, designs, and...