Talent.com
Grievance and Appeal Specialist
Grievance and Appeal SpecialistVirtualVocations • Manchester, New Hampshire, United States
Grievance and Appeal Specialist

Grievance and Appeal Specialist

VirtualVocations • Manchester, New Hampshire, United States
job_description.job_card.variable_days_ago
serp_jobs.job_preview.job_type
  • serp_jobs.job_card.full_time
job_description.job_card.job_description

A company is looking for a Grievance and Appeal Specialist.

Key Responsibilities

Conduct thorough investigations of grievances, complaints, and appeals, documenting findings

Ensure compliance with CMS reporting and data validation requirements while maintaining accurate case documentation

Participate in process improvement initiatives and assist in developing training materials and procedures

Required Qualifications

High School Diploma or GED

Minimum of 2 years of experience in appeals and grievance or a related field

Knowledge of plan products, processes, and enrollment rules

Ability to communicate operational requirements effectively

Familiarity with HIPAA and data security guidelines

serp_jobs.job_alerts.create_a_job

Grievance Specialist • Manchester, New Hampshire, United States

Job_description.internal_linking.related_jobs
Travel CT Tech - $2599.72 / Week

Travel CT Tech - $2599.72 / Week

FlexCare • Dover, NH, US
serp_jobs.job_card.full_time
FlexCare is seeking an experienced CT Tech for an exciting Travel Allied job in Dover, NH.Shift : 3x12 hr days Start Date : 11 / 03 / 2025 Duration : 12 weeks Pay : $2599. Why Clinicians Choose FlexCare.Les...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Audience Development Associate

Audience Development Associate

VirtualVocations • Lowell, Massachusetts, United States
serp_jobs.job_card.full_time
A company is looking for an Audience Development Associate to enhance engagement and attendance at conferences.Key Responsibilities Conduct outreach to prospective clients through various channel...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Member Engagement Specialist

Member Engagement Specialist

VirtualVocations • Manchester, New Hampshire, United States
serp_jobs.job_card.full_time
A company is looking for a Member Engagement Specialist.Key Responsibilities Conduct outbound engagement phone calls to members to enhance satisfaction and assist with healthcare navigation Main...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Licensed Marriage and Family Therapist

Licensed Marriage and Family Therapist

Headway • Rochester, NH, US
serp_jobs.job_card.full_time
Licensed Marriage and Family Therapist (LMFT).Wage : Between $90-$127 an hour.Licensed Marriage and Family Therapist — Are you ready to launch or expand your private practice? .Headway is here to he...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Eligibility Representative

Eligibility Representative

VirtualVocations • Lowell, Massachusetts, United States
serp_jobs.job_card.full_time
A company is looking for an Eligibility Representative 1.Key Responsibilities Processes and maintains eligibility information for individuals and employer groups Maintains accurate eligibility r...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Lead Remarketing Specialist

Lead Remarketing Specialist

VirtualVocations • Lowell, Massachusetts, United States
serp_jobs.job_card.full_time
A company is looking for a Lead, Remarketing.Key Responsibilities Manage vehicle sales in designated territory, ensuring adherence to department standards and KPIs Develop and maintain relations...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Travel Echo Tech - $2188.24 / Week

Travel Echo Tech - $2188.24 / Week

FlexCare • Dover, NH, US
serp_jobs.job_card.full_time
FlexCare is seeking an experienced Echo Tech for an exciting Travel Allied job in Dover, NH.Shift : 4x10 hr days Start Date : 11 / 03 / 2025 Duration : 13 weeks Pay : $2188. Why Clinicians Choose FlexCare.L...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Escalation Response Specialist

Escalation Response Specialist

VirtualVocations • Lowell, Massachusetts, United States
serp_jobs.job_card.full_time
A company is looking for an Escalation Response Specialist III to handle complaints and escalations from members or providers. Key Responsibilities Provide timely resolutions to escalated issues f...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Standards & Enforcement Specialist

Standards & Enforcement Specialist

VirtualVocations • Lowell, Massachusetts, United States
serp_jobs.job_card.full_time
A company is looking for a Standards & Enforcement Specialist.Key Responsibilities Enforce content guidelines by moderating flagged content and responding to tickets related to various issues Ef...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Bilingual Community Engagement Specialist

Bilingual Community Engagement Specialist

VirtualVocations • Manchester, New Hampshire, United States
serp_jobs.job_card.full_time
A company is looking for a Bilingual Community Engagement Specialist.Key Responsibilities Identify, outreach, engage, and enroll individuals into the program through various communication methods...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Appeals and Grievances Specialist

Appeals and Grievances Specialist

VirtualVocations • Manchester, New Hampshire, United States
serp_jobs.job_card.full_time
A company is looking for a Specialist, Appeals & Grievances.Key Responsibilities Facilitates research and resolution of appeals, grievances, and complaints from members and providers Researches ...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Appeals and Grievance Specialist

Appeals and Grievance Specialist

VirtualVocations • Manchester, New Hampshire, United States
serp_jobs.job_card.full_time
A company is looking for an Appeals and Grievance Specialist responsible for managing the resolution process of medical and pharmacy member appeals and complaints. Key Responsibilities : Manage mem...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Audience Activation Specialist

Audience Activation Specialist

VirtualVocations • Manchester, New Hampshire, United States
serp_jobs.job_card.full_time
A company is looking for an Audience Activation Specialist (Remote).Key Responsibilities Create custom audiences by campaign and channels as required Monitor and report on audience results and p...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Partnerships Specialist

Partnerships Specialist

VirtualVocations • Manchester, New Hampshire, United States
serp_jobs.job_card.full_time
A company is looking for a Partnerships Specialist to strengthen and grow their network of referral and channel partners. Key Responsibilities Manage and nurture existing referral and channel part...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
People Operations Specialist

People Operations Specialist

VirtualVocations • Lowell, Massachusetts, United States
serp_jobs.job_card.full_time
A company is looking for a People and Culture Operations Specialist.Key Responsibilities Provide internal customer service by supporting employees and managers with HR inquiries and developing se...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Credentialing Specialist

Credentialing Specialist

VirtualVocations • Lowell, Massachusetts, United States
serp_jobs.job_card.full_time
A company is looking for a Credentialing Specialist to support its provider network.Key Responsibilities Manage initial credentialing, re-credentialing, and payer enrollment for telehealth provid...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Client Advocacy Specialist

Client Advocacy Specialist

VirtualVocations • Lowell, Massachusetts, United States
serp_jobs.job_card.full_time
A company is looking for a Client Advocacy Specialist who will provide customer support and coordination in a fast-paced environment. Key Responsibilities Provide ongoing customer contact and supp...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Client Advocate Resolution Specialist

Client Advocate Resolution Specialist

VirtualVocations • Manchester, New Hampshire, United States
serp_jobs.job_card.full_time
A company is looking for a Client Advocate Resolution Specialist Lead.Key Responsibilities Manage and resolve complex client issues through direct interactions and off-call case work Document an...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted