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Grievance Case Analyst Jobs

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Grievance/Appeals Analyst I/II/Sr - Mason, OH/Wallingford, CT - 120027 Claims-350073 Primary Location :OH-Mason Other Locations :CT-Wallingford Description Your Talent. Our Vision.At Anthem, Inc.,it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us an...
We are seeking a Senior Appeals & Grievances Business Process Analyst to join the External Audit team within Business Process Quality Management. The Senior Business Process Analyst is responsible for the development and execution of external audit programs. The Senior Business Process Analyst will partner with Appeals & Grievances to develop an ongoing operational capability to support audit read...
STRATEGIC STAFFING SOLUTIONS HAS AN OPENING! Strategic Staffing Solutions (S3) prides itself on being an international, woman-owned, $260 million IT and business services corporation based in Detroit, Michigan. With a composite annual growth rate of 21%, S3 is fiscally sound and debt free. It is ranked 16th among the largest staffing firms in the US by Staffing Industry Report and is one of five ...
Job Description: Normal 0 false false false EN-US X-NONE X-NONE STRATEGIC STAFFING SOLUTIONS HAS AN OPENING! Strategic Staffing Solutions (S3) prides itself on being an international, woman-owned, $260 million IT and business services corporation based in Detroit, Michigan. With a composite annual growth rate of 21%, S3 is fiscally sound and debt free. It is ranked 16th among the largest ...
Company Description Mindlance is a national recruiting company which partners with many of the leading employers across the country. Feel free to check us out at http://www.mindlance.com. Job Description SUMMARY: Reviews, analyzes and processes policies related to claims events to determine the extent of the company's liability and entitlement. MAJOR JOB DUTIES AND RESPONSIBILITIES: Condu...
Overview: Provide assistance to Grievance & Appeal team in maintaining records and processing grievances and appeals for all lines of business within the timelines set by regulators. Provide assistance and guidance to internal and external customers regarding grievance/appeals policies and procedures. Ensure member satisfaction and help establish best practices. Responsibilities: Process intake...
Responsible for handling the review process for grievances, appeals, or denials including investigating, preparing and presenting appropriate materials for review. Resolves member concerns in partnership with internal and external departments while ensuring compliance with regulatory rules and timeframes within mandated timeframes and compliance. Essential Functions: Participates in handling the...
CenturyLink (NYSE: CTL) is a global communications, hosting, cloud and IT services company enabling millions of customers to transform their businesses and their lives through innovative technology solutions. CenturyLink offers network and data systems management, Big Data analytics and IT consulting, and operates more than 55 data centers in North America, Europe and Asia. The company provides br...
Description: Here, your performance, your ideas, your unique analysis will combine with a rich assortment of contributors to understand and shape the health care system. At UnitedHealth Group, you'll work with a team that has the creativity and passion to help build new health care solutions that meet emerging market needs. You'll get the opportunity to work with an elite team that goes beyond th...
Description: Here, your performance, your ideas, your unique analysis will combine with a rich assortment of contributors to understand and shape the health care system. At UnitedHealth Group, you'll work with a team that has the creativity and passion to help build new health care solutions that meet emerging market needs. You'll get the opportunity to work with an elite team that goes beyond th...
Description: Here, your performance, your ideas, your unique analysis will combine with a rich assortment of contributors to understand and shape the health care system. At UnitedHealth Group, you'll work with a team that has the creativity and passion to help build new health care solutions that meet emerging market needs. You'll get the opportunity to work with an elite team that goes beyond th...
Working At Aetna -- the Value To You What does it mean to work at Aetna? A lot. From programs and benefits that support your financial, physical and emotional health to opportunities to build your knowledge and expand your career, the company makes working here a valuable experience in many ways. POSITION SUMMARY The Sr. Complaint and Appeal Analyst  is responsible for managing to resolutio...
Description: Here, your performance, your ideas, your unique analysis will combine with a rich assortment of contributors to understand and shape the health care system. At UnitedHealth Group, you'll work with a team that has the creativity and passion to help build new health care solutions that meet emerging market needs. You'll get the opportunity to work with an elite team that goes beyond th...
Description: Here, your performance, your ideas, your unique analysis will combine with a rich assortment of contributors to understand and shape the health care system. At UnitedHealth Group, you'll work with a team that has the creativity and passion to help build new health care solutions that meet emerging market needs. You'll get the opportunity to work with an elite team that goes beyond th...
Job Duties Benefits Supplemental Questions Serves as Human Resources Coordinator for ODOT by coordinating advanced Human Resource (HR) subprograms (e.g., Position Specific Minimum Qualification validation (e.g., coordinating subject matter experts, conducting job analysis, advising managers, submission & tracking); classification plan proposals (e.g., serves as point of contact on proposals; co...
External Description: Lead Financial Analyst Are you good with people and numbers? The Air Line Pilots Association, International (ALPA) , the largest airline pilot union in the world and the largest non-governmental aviation safety organization in the world (representing over 52,000 pilots at 30 U.S. and Canadian airlines) seeks a Lead Financial Analyst for our Herndon, Virginia, office. The L...
General Overview: The Appeals Analyst reviews inquiries to determine if they meet the definition of a grievance/appeal; documents, investigates, refers and coordinates grievances and appeals; initiates a case file for each grievance and appeal; ensures compliance with organizational and regulatory requirements for member or provider issues; independently coordinates the resolution with internal/e...
Human Resources Analyst - Employee Relations and Staff Development Employer: Ventura County Community College District Date Posted: 3/21/2016 Contact: Michael Arnoldus 805-652-5500 Number Openings: (At time of posting) Not Specified Length of Work Year: Full Year Employment Type: Application Deadline: 4/3/2016 11:55 PM Pacific Salary: DOE Date Posted: 3/21/2016 Application Deadl...
Position/Program Information DEPARTMENT OF HEALTH SERVICES ORIGINAL POSTING DATE: 6/9/14 Until the needs of the service are met and is subject to closure without prior notice. EXAM NUMBER: Y5463E TYPE OF RECRUITMENT Open Competitive Job Opportunity SPECIAL SALARY INFORMATION: Physician Pay Plan: Persons employed in this position shall be compensated at the rates established in the Salary O...
Candidate will work onsite in the Chicago office. POSITION SUMMARY Assure a member and customer focus for resolution of member and provider appeals This position plays a significant role in regulatory compliance Fundamental Components: This person is the subject matter expert and independently coaches others on complaints and appeals ensuring compliance with Federal and/or State regulations.....