A company is looking for a Specialist, Appeals & Grievances.Key ResponsibilitiesResearch and resolve member and provider complaints in compliance with regulatory standardsPrepare appeal summaries and correspondence, ensuring accuracy and adherence to guidelinesAnalyze claims processing and provider contracts to determine root causes of payment errorsRequired QualificationsHigh School Diploma or equivalentMinimum 2 years of operational managed care experienceHealth claims processing background, including coordination of benefits and eligibility criteriaFamiliarity with Medicaid and Medicare claims denials and appeals processing
Grievances and Appeals Representative
A company is looking for a Grievances & Appeals Representative. ...
Complaints and Grievances Specialist
A company is looking for a Complaints & Grievances Specialist II to handle investigations and resolutions of complaints and grievances. ...
Appeals and Grievance Specialist
A company is looking for an Appeals and Grievance Specialist responsible for managing the resolution process of medical and pharmacy member appeals and grievances. ...
Collections Specialist - $20.00 per hour
Late State Collections Specialist. ...
Lead Business Analyst
A company is looking for a Lead Business Analyst to join their North America team. ...
Verisk or Riskgenius Business Systems Analyst - Remote
Manage essential process documentation and lead project implementation of functional and technical solutions by collaborating with business partners and IT leadership to gather business requirements, provide expertise and guidance and help execute plans to enhance business capability, achieve result...
Business Data Analyst
Understand the Aftermarket (Spares/Service/Repair) strategy and working toward continuous business process improvements based on immediate and future business needs, utilizing Python for data analysis and process innovation. YEARS OF OVERALL PROFESSIONAL BUSINESS ANALYSIS EXPERIENCE (Outside of IT D...
Collections Intake Specialist
Then dont miss your chance to join our Franchise as our Collections Intake Specialist. We are seeking a highly skilled and organized Collections Intake Specialist to join our team. Team Shaw is in need of an experienced Collection Intake Specialist to support its growth initiatives and mission while...
Billing and Collections Specialist
Under the supervision of the VP of Revenue Cycle Management, the Billing and Collections Specialist is responsible for the LTC/SNF claims management and collections of accounts receivable balances. This role is responsible for the revenue cycle outcomes for assigned SLP Centers by ensuring timely bi...
Seasonal Retail Commission Sales Associate - Fine Jewelry, Hulen Mall
As a Fine Jewelry Sales colleague, you provide outstanding customer service in our Fine Jewelry and Watch Complex and create shopping experiences that make every customer feel welcomed and comfortable in the Jewelry and Watch Complex. This includes meeting sales goals, promoting our loyalty and warr...