Appeals and Grievances Representative
Blue Shield
Your Role The Appeals and Grievances teams receive, document, investigate, refer, and coordinates grievances, appeals and complaints. The Appeals and Grievances Coordinator will report to the Appeals and Grievances Supervisor. In this role you will be responsible for taking incoming telephone calls, reviewing, researching, and responding to incoming appeals and grievances within established compliance timeframes. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning. #J-18808-Ljbffr Blue Shield
- ...The Appeals Representative is responsible for reviewing, analyzing, and addressing provider inquiries and appeals via email, fax, telephone, or written correspondence in accordance with regulatory guidelines, client policy and instructions, and industry standards, along...SuggestedMinimum wageFull timeLocal areaRemote workFlexible hours
$19.66 - $27.42 per hour
...of their rights and responsibilities. This position is also responsible for assisting members in navigating the grievance and appeals process and representing member interests internally and externally.**ESSENTIAL RESPONSIBILITIES*** Communicate effectively with staff,...SuggestedWork at officeWork from homeFlexible hours$24 per hour
...knowledgeable part-time Sales Specialist to join our team and represent our client at the assigned Nebraska Furniture Mart location.In... ...client product displays are well-maintained, stocked, and visually appealing to attract customers and drive sales.* **Provide Insights:**...SuggestedHourly payWeekly payPart timeImmediate startShift workWeekend work$18.5 per hour
...Customer Support Representative Astoria, NY (100% On-Site) $18.50/hour Full-Time | Temp-to-Hire We are seeking enthusiastic... ...Store Support Assist with maintaining organized and visually appealing displays Monitor inventory levels and help keep...SuggestedHourly payFull timeTemporary workLocal areaImmediate startFlexible hours- ...analyze and determine appropriate response. Prepare or process claims and adjustments in an accurate and timely manner. Prepare inbound appeals for review. Recommend and actively participate in implementing improvements in workflow and processing. May perform backup...SuggestedContract workCasual workWork at office
- ...for firm clients. You will ensure timeliness, accuracy, and compliance with Outside Counsel Guidelines, with heavy involvement in appeals and follow-up on past-due accounts. The role requires a bachelor’s degree or 3-4 years of legal billing experience, plus proficiency...
- ...to client guidelines. You will interact with partners, staff, and vendors to ensure timely billed invoices and proper follow-up on appeals and past-due accounts. The ideal candidate has experience with electronic billing, a solid understanding of accounting principles,...
$18 - $20 per hour
...standards, before, after and during the store's hours of operations. Partner with Management and Visual teams to maintain a visually appealing sales floor and ensure the brand's visual standards are always met. Properly communicate sell-through, to ensure product...Permanent employmentPart timeRemote workFlexible hoursShift workNight shiftWeekend workAfternoon shift$56.24k - $65.61k
...career? If so, join Strategic Retail Partners as a Route Service Representative in Springfield, MA ! Driven by our mission to exceed the... ...fleet. Arrange and maintain product displays to enhance visual appeal and drive sales. maintain planograms to ensure consistency across...Hourly payWeekly payTemporary workNight shift- Maximus is currently hiring Bilingual Customer Service Representatives to join our team! This position is responsible for supporting our... ...completed. Escalate unresolved, complex, or sensitive issues or grievances to designated staff or departments for further investigation...Minimum wageFull timeContract workTemporary workWork experience placementCurrently hiringRemote workHome officeMonday to FridayShift work
- ...combine their craft knowledge, accumulated over generations, with new technologies to produce iconic objects presenting both instant appeal and enduring style: true incarnations of Loewe’s ideals and vision. Radical and ever-evolving: here’s to another 200 years of Loewe...Temporary workWork experience placementFlexible hoursAfternoon shift
- ...support. Our operations team handles order processing, delivery coordination and the administrative work behind the sale so representatives can stay focused on buyers, placements and account growth. Let's Talk and Taste Send us a short introduction, your resume...Part timeFlexible hours
$52k - $62k
Wine Sales Representative Location: North NJ Compensation: $52,000–$62,000+ Type: Full-Time About the Role: Tri-Vin Wines and Spirits is seeking a highly motivated Wine Sales Representative to join our North Jersey team. The preferred home base for this role...Full timeWork from homeFlexible hours- Company Description We are a fun and efficient website design agency; we spend our days creating eye-catching, functional websites for our clients that will set them apart and improve their web presence, and in turn, their business. Our team comes comes from a ...Weekly payFull timeContract workWork experience placementLocal area
$32.5 - $36 per hour
...location in the United States. \n \n What You’ll Do: \n \n Be a Proactive Community Ambassador \n \n Enthusiastically represent TurboTax locally, serving as a fixture and public face of TurboTax in the community. \n Engage with new prospects, nurture...Local area- Fisher Phillips LLP is seeking an Insurance Appeals Specialist to join our Legal Project Management Team. This role focuses on managing, researching, interpreting, and drafting timely, Billing Guideline-compliant responses to deductions by insurance companies on defense...Remote job
- ...Part-Time Brand Ambassador / Sales Representative MDX Global is hiring high-energy Brand Ambassadors to represent Sebamed skincare at... ...by results. Set up and maintain a professional, visually appealing demo station inside Costco Actively engage passing shoppers...Base plus commissionHourly payPart timeFlexible hoursShift work
- ## Representative, PFM Business IntelligenceApplylocations: Headquarters, Winston Salem, NCtime type: Full timeposted on: Posted Yesterdayjob... ...identifying MAC, pricing and contract exceptions, submitting appeals to the carriers, recording responses from the carriers,...Contract workTemporary workWork at officeImmediate startFlexible hours
- ...of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer. The following additional conditions may apply, some of which are dependent upon...Work at officeMonday to FridayDay shift
- ...Analyze insurance denials, determining denial reasons, assessing validity, and completing the appropriate resolution steps such as appeals, corrections, or resubmissions Communicate directly with insurance carriers via outbound calls to obtain claim status, clarify discrepancies...Remote jobWork from homeMonday to Friday
$19.24 per hour
...caring community The Medicare Call Center Rep (Inbound Contacts Representative 2) represents Humana by addressing incoming telephone,... ...appropriate action, including escalating unresolved and pending member grievances. Decisions are typically focused on interpretation of area /...Hourly payTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeMonday to FridayShift workWeekend work$34.95 - $41.74 per hour
...of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer. The following additional conditions may apply, some of which are dependent upon...Hourly pay16 hoursPart timeWork at officeLocal area- Job Summary: The Account Representative, Senior is responsible for all fiscal functions necessary to ensure the prompt and correct payment... ...steps to eliminate future occurrences of denials. Assist in claim appeal process and/or perform follow-up in accordance with Revenue...
$8,571 - $10,571 per month
...consultation to management regarding discipline, third level grievance processes, and other labor relations issues along with researching... .... As assigned by the Labor Relations Administrator, represents agency in master contract negotiations, supplemental negotiations...Permanent employmentFull timeContract workH1bWork at officeRemote workFlexible hoursNight shift- ...stores. Execute planograms and visual merchandising standards accurately. Maintain organized, properly signed, rotated, and visually appealing displays. Monitor inventory and help reduce out-of-stocks. Recommend new products based on customer and store needs. Process...Full timeTemporary workLive inWork at officeRemote workMonday to FridayShift workNight shift
- ...What you will be doing: Develop and maintain effective account relationships and promote the goodwill of the company Represent our world-class brands in a dynamic market Grow brand presence within our existing accounts. Proper merchandising of accounts...Permanent employmentFull timeWork experience placementLocal areaFlexible hoursAfternoon shift
$25 - $28 per hour
...Behavioral Hospital of Bellaire is seeking a Patient Account Representative to maximize reimbursement of patient and third-party account... ...assistance and resolution. Follow up with payers on hospital claim appeals. Pay Rate: $25/hr - $28/hr This opportunity provides the...Work at officeLocal area- ...The Patient Account Representative’s responsibilities include liaising with medical insurance providers to process claims in a timely and... ...well as underpayments from third party payers and processes appeals and/or claim(s) reconsiderations to insurance companies in a...Work at officeFlexible hours
$124.32k - $186.48k
At Bayer we’re visionaries, driven to solve the world’s toughest challenges and striving for a world where 'Health for all Hunger for none’ is no longer a dream, but a real possibility. We’re doing it with energy, curiosity and sheer dedication, always learning from unique...Local area- Are you ready to make an impact at DTCC? Do you want to work on innovative projects, collaborate with a dynamic and supportive team, and receive investment in your professional development? At DTCC, we are at the forefront of innovation in the financial markets. We are...Contract workWork at officeRemote workFlexible hours
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