Talent.com
Appeals and Grievances Specialist
Appeals and Grievances SpecialistVirtualVocations • Tampa, Florida, United States
Appeals and Grievances Specialist

Appeals and Grievances Specialist

VirtualVocations • Tampa, Florida, 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 • Tampa, Florida, United States

Job_description.internal_linking.related_jobs
Claims Service Specialist

Claims Service Specialist

GEICO • Lakeland, FL, US
serp_jobs.job_card.full_time
At GEICO, we offer a rewarding career where your ambitions are met with endless possibilities.Every day we honor our iconic brand by offering quality coverage to millions of customers and being the...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Senior Claims Specialist, Financial Lines Management Liability

Senior Claims Specialist, Financial Lines Management Liability

Liberty Mutual Insurance Group • Tampa, FL, US
serp_jobs.job_card.full_time
Senior Claims Specialist, Financial Lines Management Liability.Liberty Mutual has an immediate opening for a Senior Claims Specialist, Financial Lines Management Liability position.In this role, wi...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Recertification Specialist - HUD / LIHTC

Recertification Specialist - HUD / LIHTC

TRG Management • Tampa, FL, US
serp_jobs.job_card.temporary
Recertification Specialist - HUD / LIHTC.This position is responsible for conducting annual examinations and processing annual certifications of the residents for continued participation in the progr...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Accreditation Specialist

Accreditation Specialist

Vets Hired • Florida, Florida, United States
serp_jobs.job_card.full_time
serp_jobs.filters_job_card.quick_apply
Assists in directive, policy, and procedure development, revisions, and additions.Establishes, organizes, and assists in the collection of documentation for all accreditation files.Maintains accred...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30
Decedent Solutions Associate

Decedent Solutions Associate

Raymond James Financial • Saint Petersburg, FL, US
serp_jobs.job_card.full_time
Provides standard client support services, assisting internal associates and / or Financial Advisors in researching and resolving escalated issues. Recommends solutions to moderately complex problems....serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Business Insurance Placement Specialist

Business Insurance Placement Specialist

Marsh McLennan • Clearwater Beach, FL, US
serp_jobs.job_card.full_time
Business Insurance Placement Specialist.Marsh McLennan Agency (MMA) provides business insurance, employee health & benefits, retirement, and private client insurance solutions to organizations and ...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
NOW HIRING : Licensed Insurance Agent – Mentorship Track to Become an Infinite Banking Specialist

NOW HIRING : Licensed Insurance Agent – Mentorship Track to Become an Infinite Banking Specialist

GIA Legacy Planning • Clearwater, Florida, US
serp_jobs.job_card.full_time
serp_jobs.filters_job_card.quick_apply
Remote | 💼 Commission-Based | 🎓 Mentorship Included.Are you a licensed insurance agent looking to take your career to the next level?. Are you curious about Infinite Banking, tax-free wealth strat...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30
Affiliate Specialist

Affiliate Specialist

BenefitHub • Tampa, FL, US
serp_jobs.job_card.full_time
Reporting to : Director of Partnerships.Proofread, test and implement changes to content from affiliates.Coordinate across teams to communicate updates. Assist Senior Affiliate Manager with content u...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Subrogation Specialist - Hybrid

Subrogation Specialist - Hybrid

USAA Careers • TAMPA, Florida, US
serp_jobs.job_card.full_time +1
At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Subrogation Specialist - Hybrid

Subrogation Specialist - Hybrid

USAA • Tampa, FL, US
serp_jobs.job_card.full_time
At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
Billing Intake Engagement Specialist

Billing Intake Engagement Specialist

Holland & Knight • Brandon, FL, US
serp_jobs.job_card.full_time
Billing Engagement Intake Specialist.We are a Firm where people truly believe in what they do and strive to achieve the highest standards of performance and success. This position can be based in ou...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Appellate Litigation Associate

Appellate Litigation Associate

SLR Search • Tampa, FL, US
serp_jobs.job_card.full_time
Advance your legal career at a leading firm offering exceptional opportunities for professional growth and a supportive work environment. Appellate Litigation Associate Benefits : .Starting Salary Tar...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Medical Claims Specialist - Remote

Medical Claims Specialist - Remote

Rising Medical Solutions • Tampa, FL, US
serp_jobs.filters.remote
serp_jobs.job_card.full_time
The Claims Specialist will assist in reviewing, processing, and coordinating claims accurately in accordance with the program requirements while ensuring compliance and enhancing client relationshi...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Acquisitions Development Specialist

Acquisitions Development Specialist

Mid-Atlantic Finance Company • Clearwater Beach, FL, US
serp_jobs.job_card.full_time
Now Hiring! Acquisitions Development Specialist.Total compensation $42,000 and up (with base and bonus) Onsite in our Clearwater, FL location (Ulmerton Rd). Summary : We are looking for an energetic ...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Loyalty Specialist I

Loyalty Specialist I

Kobie Marketing • Saint Petersburg, FL, US
serp_jobs.job_card.full_time
Named a Top Workplace in the USA, and Top Remote Workplace, Kobie is where the best minds in loyalty come together, driven by passion and innovation. We’re always looking for talented individu...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Customer Relations Specialist

Customer Relations Specialist

Suburban Propane • Tampa, FL, US
serp_jobs.job_card.full_time
We are currently looking for a Customer Relations Specialist to play a pivotal role in helping to support excellent customer service, customer retention and new customer acquisition.As a Customer R...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
Senior Claims Specialist

Senior Claims Specialist

CorVel • Tampa, FL, US
serp_jobs.job_card.full_time
The Senior Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims within delegated limited authority to determin...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Vendor Relations Specialist

Vendor Relations Specialist

PrideStaff • Palm Harbor, FL, US
serp_jobs.job_card.full_time
Our client is seeking individuals who are comfortable in an office making outbound calls to current vendors of their services. This is an exciting opportunity to join a casual, family-oriented compa...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Bankruptcy and Creditors' Rights Associate

Bankruptcy and Creditors' Rights Associate

Wallman Unlimited Company • Tampa, FL, US
serp_jobs.job_card.full_time
Our client, a prestigious Am Law 200 firm, is seeking an Associate to join its Bankruptcy and Creditors' Rights Practice Group in the Tampa office. Qualifications & Requirements : .Admission (...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Bankruptcy and Creditors' Rights Associate Tampa

Bankruptcy and Creditors' Rights Associate Tampa

Mosaic Recruits • Tampa, FL, US
serp_jobs.job_card.full_time
A leading national firm is seeking an associate to join its bankruptcy and creditors’ rights practice group in Tampa.The ideal candidate will have : . Excellent academic credentials and strong w...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted