![Centene Corporation](https://media.trabajo.org/img/noimg.jpg)
Grievance and Appeals Coordinator II
1 month 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.
Position Purpose:
Analyze and resolve verbal and written claims and authorization grievance/appeals from providers and members. Resolve all State inquires related to complaints, grievances and appeals.
• Review and process member and provider grievances and appeals within federal, state and organizational regulations and policies and procedures
• Review claim grievance for reconsideration and either approve/deny based on determination level or prepare for medical review presentation. Prepare cases for medical review as necessary
• Review and determine if claim grievance includes a potential quality or access issue
• Collaborate with subject matter experts within the organization to obtain benefit and/or clinical opinions/interpretations of complex cases
• Serve as liaison between member, provider regulatory agencies and internal staff. Correspond with key individuals regarding grievance and appeal decisions.
• Act as subject matter expert regarding grievances and appeals.
• Lead Appeals and Grievance Committee
Education/Experience: Bachelor’s degree in related field or equivalent experience. 2+ years of claims, contracting, or related experience in a managed care environment.
Centene 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.
-
Grievance and Appeals Coordinator II
1 month ago
Tempe, United States Centene Corporation Full timeYou 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.**Position Purpose:**Analyze and resolve verbal and written claims and...
-
Grievance and Appeals Coordinator II
4 weeks ago
Tempe, United States Arizona Complete Health Full timeYou 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. Position Purpose: Analyze and resolve verbal and written claims and...
-
Grievance and Appeals Coordinator II
1 month ago
Tempe, United States Arizona Complete Health Full timeYou 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. Position Purpose: Analyze and resolve verbal and written claims and...
-
Grievance and Appeals Coordinator II
4 weeks ago
Tempe, United States Arizona Complete Health Full timeYou 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. Position Purpose: Analyze and resolve verbal and written claims and...
-
Grievance and Appeals Coordinator II
4 weeks ago
Tempe, United States Arizona Complete Health Full timeYou 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. Position Purpose: Analyze and resolve verbal and written claims and...
-
Grievance and Appeals Coordinator II
4 days ago
Tempe, United States Arizona Complete Health Full timeYou 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. If the following job requirements and experience match your skills, please...
-
Grievance and Appeals Coordinator II
2 days ago
Tempe, United States Arizona Complete Health Full timeYou 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. Position Purpose: Analyze and resolve verbal and written claims and...
-
Grievance and Appeals Coordinator II
4 weeks ago
Tempe, United States Arizona Complete Health Full timeYou 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. Position Purpose: Analyze and resolve verbal and written claims and...
-
Grievance and Appeals Coordinator II
4 weeks ago
Tempe, United States Arizona Complete Health Full timeYou 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. Position Purpose: Analyze and resolve verbal and written claims and...
-
Grievance and Appeals Coordinator II
1 month ago
Tempe, United States Arizona Complete Health Full timeYou 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. Position Purpose: Analyze and resolve verbal and written claims and...
-
Grievance and Appeals Coordinator II
4 weeks ago
Tempe, United States Arizona Complete Health Full timeYou 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. Position Purpose: Analyze and resolve verbal and written claims and...
-
Grievance and Appeals Coordinator II
2 weeks ago
Tempe, Arizona, 85282, Maricopa County, AZ, United States Arizona Complete Health Full timeYou 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. Position Purpose: Analyze and resolve verbal and written claims and...
-
Grievance and Appeals Coordinator II
2 days ago
Tempe, AZ, United States Arizona Complete Health Full timeYou 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. Position Purpose: Analyze and resolve verbal and written claims and...
-
Grievance and Appeals Coordinator II
1 day ago
Tempe, AZ, United States Arizona Complete Health Full timeYou 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. Position Purpose: Analyze and resolve verbal and written claims and...
-
Collections Coordinator II
1 month ago
Tempe, United States Global Lending Services Full timeJob DescriptionJob DescriptionWhy GLS? Purpose: Access to affordable, reliable transportation is essential to leading productive work and personal lives, caring well for oneself, one’s family, and the needs of others. Through advanced analytics and technology, we can more accurately predict credit risk and provide more people with an affordable auto...
-
Security Systems Technician Ii
2 weeks ago
Tempe, United States IES Communications Full time**Job Description**: **ob Summary**: The Security Systems Technician II must possess the ability to program and install security systems (Card Access, CCTV, CATV and Intrusion systems) per manufacturer requirements and engineered drawings. The Security Systems Technician II will coordinate small groups of installers in the performance of daily workload...
-
Technician Ii
4 weeks ago
Tempe, United States IES Communications Full time**Job Description**: **Job Summary**: The Technician II - Structured Cabling must possess the ability to perform the technical responsibilities of a Cable Installer and function as a lead member of a technical team. The Technician II will coordinate small groups of installers in the performance of daily workload including adherence to Company safety and...
-
Mortgage Servicing Customer Care Coordinator II
1 month ago
Tempe, United States BNP Paribas Bank NV Full timeWe are looking for **Mortgage Servicing Customer Care Coordinator II** **Location** At Bank of the West, our people are having a positive impact on the world. Were investing where we feel we can make the most impact, like advancing diversity and women entrepreneurship programs, financing for more small businesses, and promoting programs for sustainable...
-
Marketing Coordinator
3 weeks ago
Tempe, United States Jeeter Full time**Marketing Coordinator** - DreamFields is one of the top 5 cannabis companies in the industry through our leading #1 pre-roll brand, Jeeter. The company is very passionate about producing world-class marketing, high quality, innovative products, delivering unprecedented customer experiences, having cutting-edge operations, and curating an amazing company...
-
Marketing Coordinator
4 weeks ago
Tempe, United States Jeeter Full timeJob Title: Marketing Coordinator Department: Marketing Reports to: Field Marketing Manager Effective Date: 4/19/2024 DreamFields is one of the top 5 cannabis companies in the industry through our leading #1 pre-roll brand, Jeeter. The company is very passionate about producing world-class marketing, high quality, innovative products, delivering...