Position Summary: The Appeals & Grievances Clinical Specialist is responsible for receiving, investigating and responding verbally and in writing to member and provider clinical appeals and grievances. Duties and Responsibilities: Ensures that appeals and grievances are properly classified (e.g.
Benefits Comprehensive Health Coverage – Medical, dental, and vision plans to keep you and your family healthy. Future Security: 401(k) with matching Student Loan Support – Up to $10,000 repayment assistance, because we invest in your
Req ID: 379955 NTT DATA strives to hire exceptional, innovative and passionate individuals who want to grow with us. If you want to be part of an inclusive, adaptable, and forward-thinking organization, apply now. We are
About Allsup, LLC Allsup LLC is a people-centered organization with a team of hundreds who are dedicated to helping people with disabilities lead lives that are as financially secure and healthy as possible. We enjoy working
Overview The Senior Auditor, Appeals position is part of the Clinical Chart Validation (CCV) team and is responsible for defending Cotiviti’s recovery determinations utilizing the appropriate guidelines including but not limited to Commercial, CMS inpatient and outpatient
At UnitedHealthcare, were simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective
Job Description The New York City Law Department is seeking applicants for the position of Assistant Corporation Counsel in its Appeals Division. The Appeals Division litigates appeals arising from nearly all of the Law Department’s practice areas and prepares
About Us: Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to
About The Lisinski Law Firm Since 2020, Lisinski Law Firm has served as a dedicated humanitarian immigration practice committed to providing meaningful support to individuals and families seeking safety, stability, and a path forward. We frequently
Become a part of our caring community The Grievances & Appeals Representative 3 manages client denials and concerns by conducting a comprehensive analytic review of clinical documentation to determine if a grievance, appeal or further request is warranted
JOB DESCRIPTION Job Summary Provides support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution to members or authorized representatives in accordance with the standards and requirements established by the Centers
Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to
At Curana Health, were on a mission to radically improve the health, happiness, and dignity of older adults—and were looking for passionate people to help us do it. As a national leader in value-based care, we
Amazing Opportunity and Great Place to Work! Do you have advanced experience in absence management leadership? Our Story At Alight, we believe a company’s success starts with its people. Alight embraces values that come directly from
Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the
Realistic Job Preview Video Remote in Texas, Kansas, Missouri, Arkansas, Illinois, Wisconsin, Iowa, Tennessee, North Dakota, South Dakota, Nebraska, Minnesota, Louisiana, Mississippi, Alabama or Florida Optum is a global organization that delivers care, aided by technology,
General Information Press space or enter keys to toggle section visibility Work Location: Los Angeles, CA, USA Onsite or Remote Flexible Hybrid Work Schedule Monday - Friday, 7:00am - 3:30pm PST Posted Date 07/22/2026 Salary Range:
This is a Contractual role At Amazon we believe that every day is still Day One. We are striving to be Earth’s Best Employer and to get there, we need exceptionally talented, bright, and driven people.
Benefits Comprehensive Health Coverage – Medical, dental, and vision plans to keep you and your family healthy. Future Security: 401(k) with matching Student Loan Support – Up to $10,000 repayment assistance, because we invest in your