Grievance & Appeals Coordinator I
Found in: Talent US C2 - 2 weeks ago
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
Remote opportunity in California
Our HealthNet team is hiring for a Grievance & Appeals Coordinator I in the State of California. This position will require travel into the office for occasional meetings.
Position Purpose: Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members.
Gather, analyze and report verbal and written member and provider complaints, grievances and appeals
Prepare response letters for member and provider complaints, grievances and appeals
Maintain files on individual appeals and grievances
May coordinate the Grievance and Appeals Committee
Support the pay-for-performance programs, including data entry, tracking, organizing, and researching information
Assist with HEDIS production functions including data entry, calls to provider’s offices, and claims research.
Manage large volumes of documents including copying, faxing and scanning incoming mail
Education/Experience: High school diploma or equivalent. Associate’s degree preferred. 2+ years grievance or appeals, claims or related managed care experience. Strong oral, written, and problem solving skills.Pay Range: $18.66 - $31.73 per hourCentene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.
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Found in: beBee jobs US - 4 days ago
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Found in: beBee S US - 2 weeks ago
Los Angeles, United States L.A. Care Health Plan Full timeSalary Range: $67,186.00 (Min.) - $87,342.00 (Mid.) - $107,498.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million...
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Customer Solution Center Appeals and Grievances Quality Auditing Specialist II
Found in: beBee jobs US - 2 weeks ago
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $67, Min.) - $87, Mid.) - $107, Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make...
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Found in: beBee jobs US - 1 week ago
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Customer Solution Center Appeals and Grievances Quality Auditing Specialist II
Found in: beBee S US - 1 week ago
Los Angeles, United States L.A. Care Health Plan Full timeSalary Range: $67,186.00 (Min.) - $87,342.00 (Mid.) - $107,498.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million...
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Customer Solution Center Appeals and Grievances Specialist II
Found in: beBee jobs US - 1 week ago
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $60, Min.) - $75, Mid.) - $91, Max.)Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make sure...
