Compliance Resolution Coordinator

Company Overview:The Blue Cross and Blue Shield Association is a premier healthcare organization committed to delivering exceptional services to its members. Our team within the Appeals and Grievance Department plays a crucial role in processing and responding to appeals, grievances, and inquiries from regulatory agencies, CalPERS members, and other...

About This RoleAs a Healthcare Advocate Coordinator at Blue Shield of California, you will play a critical role in managing and resolving member appeals and grievances in a timely manner.Your key responsibilities will include answering inquiries, investigating issues, and providing explanations of health plan benefits to members and providers. To succeed in...

Job OverviewThe CalPERS team within the Appeals and Grievance Department plays a crucial role in processing and responding to appeals, grievances, and inquiries received from CalPERS members, regulatory agencies, and CalPERS directly. This team ensures timely and effective resolution of complex cases, maintaining the highest level of professionalism and...

**About Blue Shield of California**Blue Shield of California is a health plan dedicated to providing high-quality, affordable healthcare services to our members. We are committed to improving the health and well-being of our community by delivering exceptional customer service, promoting healthy lifestyles, and supporting innovative healthcare...

Your RoleAt Blue Shield of California, our Appeals and Grievances team plays a crucial role in receiving, documenting, investigating, referring, and coordinating grievances, appeals, and complaints. As an Appeals and Grievances, Advanced Coordinator, you will report to the Appeals and Grievances Supervisor. In this position, you will be responsible for...

Your Role The Commercial First Pass Claims team is responsible for processing work in Enrollment, Claims, Provider, or other operational areas to meet operational, financial, and service requirements. These include timely and proper enrollment, adjudication of claims, or provider demographics updates in accordance with contractual requirements.The Claims...

Job DescriptionIn this exciting role as a Regulatory Complaint Coordinator, you will be part of a dynamic team that handles appeals, grievances, and inquiries for CalPERS. You will work closely with regulatory agencies, CalPERS members, and other stakeholders to provide excellent customer service while ensuring compliance with regulatory requirements.About...

Job Title: Claims Operations Coordinator">About the Role:">We are seeking a highly organized and detail-oriented Claims Operations Coordinator to join our team at ServiceMaster Restore 9669 - Irvine. In this role, you will be responsible for managing claims from start to finish, ensuring timely resolution and customer satisfaction.">Key...

OverviewThe Appeals and Grievances team at Blue Shield of California plays a crucial role in managing and resolving member appeals and grievances. As an Appeals and Grievances Representative, Advanced Coordinator, you will be responsible for taking incoming telephone calls, reviewing, researching, and responding to appeals and grievances within established...

Human Resources/Payroll Assistant at EVERS ELECTRIC CO., INC.We are seeking a highly skilled Human Resources/Payroll Assistant to join our team. The successful candidate will be responsible for performing various HR and payroll functions, including maintaining employee records, processing payroll, managing benefits, and facilitating employee onboarding.Key...

About the RoleWe are seeking a highly skilled Regulatory Complaint Coordinator, Intermediate-CalPERS to join our team at Blue Shield of California. In this role, you will be responsible for processing and responding to Appeals and Grievances as well as inquiries received directly from CalPERS members, regulatory agencies and CalPERS directly.As a key member...

Valmont Industries, Inc. is a Fortune 1000 company that respects hard work, honors diversity and invests in our employees as we focus on creating the world of tomorrow, today.We are seeking an experienced Safety Specialist to join our team in El Dorado, Kansas. This role is responsible for providing environmental, health and safety support and ensuring that...

Comprehensive Mammography ServicesAt Onsite Women's Health, we're dedicated to delivering exceptional breast care to women nationwide.In partnership with forward-thinking healthcare providers, our mission is to improve women's health through innovative mammography services and clinical expertise.We offer personalized, convenient breast care solutions that...

Job SummaryThis is an exciting opportunity to work in a dynamic instructional and learning environment that fosters student engagement, equal opportunity, and innovation in meeting the various educational and career goals of our diverse students. As an Administrative Assistant II, you will play a key role in supporting the faculty, staff, and students in the...

We are seeking an experienced Director of Compliance and IT Audit to lead our IT compliance and audit functions. This role requires a highly experienced individual with a deep understanding of IT governance, risk management, and compliance principles.About Strategic Resource Partners Inc:We are a forward-thinking company dedicated to delivering innovative...

About Redwood Family Care NetworkRedwood Family Care Network is an innovative leader in delivering person-centered home and community-based services to individuals with intellectual and developmental disabilities.Salary InformationWe offer a competitive salary range of $70,000 - $73,000 per year, based on the location and experience.Job DescriptionThe...

OverviewMercy Medical Group, a dynamic and growing multi-specialty medical group with over 500 healthcare providers in the Sacramento region, is seeking skilled and compassionate pediatricians to join our team at our Cameron Park, CA clinic.Estimated Salary: $120-$127/hourThis role offers a unique opportunity to provide comprehensive medical care to infants,...

Overview">Mercy Medical Group, a leading multi-specialty medical group with over 500 healthcare providers in the Sacramento region, is seeking skilled and compassionate pediatricians to join our dynamic Pediatrics Department at our Cameron Park, CA clinic. As a pediatrician, you will play a crucial role in providing comprehensive medical care to infants,...

Key ResponsibilitiesExecutes strategic, proactive, and complex calendar/meeting/event planning, management and conflict resolutionArranges travel coordination, logistics, and expense reporting for leadershipOversees coordination of employee support for the group/division/sub-division (on-boarding, timesheet administration/auditing, training requirements,...

About the RoleWe are seeking a highly skilled Clinical Research Associate I to join our team at Cedars-Sinai Medical Center. This hybrid role requires an onsite presence of 2-3 days per week and applicants must reside in the Los Angeles area to be considered.The successful candidate will work directly with a Clinical Research Coordinator, Research Program...