Talent.com
Appeals and Grievances Specialist
Appeals and Grievances SpecialistVirtualVocations • Milwaukee, Wisconsin, United States
Appeals and Grievances Specialist

Appeals and Grievances Specialist

VirtualVocations • Milwaukee, Wisconsin, United States
job_description.job_card.30_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 Specialist, Appeals & Grievances.

Key Responsibilities

Facilitates research and resolution of appeals, grievances, and complaints from members and providers

Researches claims appeals and grievances to determine appropriate outcomes and ensures compliance with guidelines

Prepares appeal summaries and correspondence, documenting findings and trends as required

Required Qualifications

At least 2 years of managed care experience in a call center, appeals, or claims environment

Health claims processing experience, including coordination of benefits and eligibility criteria

Experience with Medicaid and Medicare claims denials and appeals processing

Customer service experience

Proficiency in Microsoft Office suite or applicable software programs

serp_jobs.job_alerts.create_a_job

Grievance Specialist • Milwaukee, Wisconsin, United States

Job_description.internal_linking.related_jobs
Associate Campaign Manager

Associate Campaign Manager

Uline • Pleasant Prairie, WI, US
serp_jobs.job_card.full_time
Uline Drive, Pleasant Prairie, WI 53158.Take your marketing skills to the next level - at Uline! As an Associate Campaign Manager, you will dig into campaign data to make optimizations across tradi...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Credit Team Lead

Credit Team Lead

Uline • Pleasant Prairie, WI, US
serp_jobs.job_card.full_time
Uline Drive, Pleasant Prairie, WI 53158.Are you an emerging leader in the financial field with a passion for collaboration, training and teamwork? Then you belong at Uline! As a Credit Team Lead, y...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Regional Support Specialist

Regional Support Specialist

Putzmeister • Sturtevant, WI, US
serp_jobs.job_card.full_time
Supports external PMA personnel attending to daily queries and issues as well as unique customer issues.F;Provides excellent inter-departmental coordination to ensure seamless PMA workflow practice...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
HR Investigator

HR Investigator

Rogers Behavioral Health • Oconomowoc, WI, United States
serp_jobs.job_card.full_time
The HR Investigator is responsible for conducting thorough and impartial workplace investigations, administering our case management system (EthicsPoint / Navex), partnering with HR Advisors on resol...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Financial Services - Accounts Receivable

Financial Services - Accounts Receivable

Uline • Pleasant Prairie, WI, US
serp_jobs.job_card.full_time
Financial Services - Accounts Receivable.Pay from $22 to $23 per hour with significant growth and earning potential!.Uline Drive, Pleasant Prairie, WI 53158. New hires earn a $2,500 year-end bonus!....serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Claims Specialist

Claims Specialist

Artera • USA, Wisconsin, Milwaukee
serp_jobs.job_card.full_time
Manage all claims while under the general supervision of the Claims Director.Provide monthly updates and reporting.Coordination and database management. and other projects as assigned by the manage...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30
Bidding and Proposal Specialist - Asphalt Paving

Bidding and Proposal Specialist - Asphalt Paving

Asphalt Contractors Inc • Union Grove, WI, US
serp_jobs.job_card.full_time
Are you a detail-oriented professional with a passion for project estimation and analysis?.Become part of a reputable family-owned business with over 40 years of industry excellence.As a full-servi...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Accounts Receivable Specialist

Accounts Receivable Specialist

LHH • Germantown, WI, US
serp_jobs.job_card.full_time
Accounts Receivable Specialist.We are hiring for an Accounts Receivable Specialist in Germantown, WI.This role will be part of a growing team supporting a nationwide organization.If you have at lea...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Concessions Attd

Concessions Attd

Marcus Theatres Corporation • Sturtevant, WI, United States
serp_jobs.job_card.part_time
Variable Shifts; Part Time; Free Movies - Amazing Growth Opportunities - Renaissance - Concession Attendant.Under the direction of the theatre management team, the. Tasks will be handled in a friend...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted
Credentialing and Follow-Up Specialist

Credentialing and Follow-Up Specialist

Outreach Community Health Centers • Milwaukee, WI, United States
serp_jobs.job_card.full_time
The Credentialing and Follow Up Specialist roles combines three key areas : provider credentialing, medical coding, and insurance account receivable follow-up. The Credentialing and Follow Up Special...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Manager, Contract Negotiations (Biosimilars)

Manager, Contract Negotiations (Biosimilars)

Fresenius Kabi USA, LLC • Pleasant Prairie, WI, United States
serp_jobs.job_card.full_time
The Manager, Contract Negotiations is primarily responsible for managing complex lead negotiations for large and / or complex client contracts across various Fresenius Kabi markets, including but not...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Employee Relations Specialist

Employee Relations Specialist

KION Group • Milwaukee, WI, US
serp_jobs.job_card.full_time
Grand Rapids, MI, United States.Dematic is looking for an Employee Relations (ER) Specialist with previous employee relations experience, subject matter knowledge, strong communication (written / v...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Financial Rep – Upcoming Grad - Starting at $16 / hr

Financial Rep – Upcoming Grad - Starting at $16 / hr

Mutual of Omaha • Waukesha, WI, US
serp_jobs.job_card.full_time
Financial Representative Trainee (Sales) - Milwaukee, WI.Sales, Early Career Programs, Financial Representative Trainee.Are you driven, self-motivated, and eager to jumpstart your career in the fin...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Negotiations Specialist

Negotiations Specialist

TradeJobsWorkForce • 53167 Rochester, WI, US
serp_jobs.job_card.full_time
Negotiations Specialist Job Duties : Call providers, navigate call trees to get to the right people Negoti...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Mailroom Specialist

Mailroom Specialist

Rausch Sturm LLP • Brookfield, WI, United States
serp_jobs.job_card.full_time
Rausch Sturm LLP, a creditor's rights law firm, located in Brookfield, WI is interested in YOU potentially joining our team. This logistics specialist position is primarily administrative in nature ...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Employee Relations Manager, NA

Employee Relations Manager, NA

Vantage Data Centers • Port Washington, WI, United States
serp_jobs.job_card.full_time
Vantage Data Centers powers, cools, protects and connects the technology of the world's well-known hyperscalers, cloud providers and large enterprises. Developing and operating across North America,...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Strategic Accounts Sales Support Specialist

Strategic Accounts Sales Support Specialist

Airgas • Germantown, WI, US
serp_jobs.job_card.full_time
Strategic Accounts Sales Support Specialist.Location : Germantown, WI (LLC Support) - Management.How Will You Contribute and Grow?. We are hiring! At Airgas, we respect, honor and value diversity.We ...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Account Executive

Account Executive

Staffing Support Specialists • Hartford, WI, United States
serp_jobs.job_card.full_time
Staffing Support Specialists LLC.We are looking for someone who understands our.We aren't just here for a paycheck, we're here to make a difference. If you like to take initiative and accomplish goa...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Mailroom Specialist

Mailroom Specialist

Rogers Behavioral Health • Oconomowoc, WI, United States
serp_jobs.job_card.full_time
Under the direction of the Director of Purchasing, the Mail Room Specialist will maintain day to day operations for Rogers Behavioral Health mail rooms and provide mail services throughout the Roge...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Professional Career Opportunities

Professional Career Opportunities

Construction Resources Management • Waukesha, WI, United States
serp_jobs.job_card.full_time
Professional Career Opportunities at.Wisconsin, Illinois & Michigan.Multi-Year Milwaukee Business Journal "Best Place to Work" Winner. Founded as a third-generation, family-owned construction and en...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted