Appeals & Grievances Specialist

CVS Health

CVS Health is seeking a dedicated Appeals Specialist to manage intake, investigation and resolution of member appeals and grievances. You will coordinate across clinical and operations units to deliver timely, accurate responses, identify trends, and propose solutions. Strong analytical skills and knowledge of benefits language are essential. Responsibilities include researching benefit language and plan design, verifying claim data, and ensuring compliance with policies while communicating #J-18808-Ljbffr CVS Health

Apply

Vacancy posted 4 days ago

Similar jobs that could be interesting for youBased on the Appeals & Grievances Specialist in Frankfort, KY vacancy

Appeals & Grievances Specialist
...CVS Health is seeking a dedicated Appeals Specialist to manage intake, investigation and resolution of member appeals and grievances. You will coordinate across clinical and operations units to deliver timely, accurate responses, identify trends, and propose solutions...
Suggested
CVS Health
Frankfort, KY
3 days ago
Revenue Cycle Specialist I
$19.41 - $28.14 per hour
...correspondence and payor calls; assist as needed on aging reports, reports all payor issues and/or denial trends to Lead/Supervisor and may appeal and/or rebill underpaid claims and assist with payments, as needed. We are committed to offering flexible work options where...
Suggested
Hourly pay
Full time
Contract work
Work at office
Remote work
Flexible hours
Intermountain Healthcare
Frankfort, KY
2 days ago
Remote Family Protection Specialist
AO Garcia Agency is seeking a home-based client relations role that offers a flexible schedule and the option for full-time or part-time engagement. You will run video meetings, work warm leads, and build a client book with coaching and a proven process provided. Success...
Suggested
Full time
Part time
Remote work
Work from home
Flexible hours
AO Garcia Agency
Frankfort, KY
3 days ago
Housing Specialist
...landlord inquires.SUPERVISION RECEIVED AND EXERCISED:Operates under the direct general supervision of a Supervisor; the Housing Specialist exercises no supervision over other employees. ESSENTIAL DUTIES AND RESPONSIBILITIES: The below statements are intended to describe...
Suggested
Work experience placement
Interim role
Local area
Nan McKay and Associates
Frankfort, KY
1 day ago
Order Specialist
Select how often (in days) to receive an alert: Create Alert Essilor Instruments provides seamless access to state-of-the-art products, with a focus on customer satisfaction by setting new standards of excellence in the industry. Our solutions highlight eye care professionals...
Suggested
Minimum wage
Work at office
Local area
EssilorLuxottica
Frankfort, KY
1 day ago
Remote Revenue Cycle Specialist I
Intermountain Health is seeking a fully remote Claims Follow-Up Specialist to ensure timely follow-up on billed claims and resolution of accounts. You will maintain billing guidelines, fee schedules, and contract rates, and review all incoming correspondence and payor...
Remote job
Contract work
Intermountain Healthcare Inc.
Frankfort, KY
1 day ago
Senior Specialist, Account Management
$57k - $81.6k
US-Nationwide-FIELD Full time 20188497 What Account Management contributes to Cardinal Health: Account Management is responsible for cultivating and maintaining on-going customer relationships with an assigned set of customers. Provides new and existing customers...
Full time
Temporary work
Work experience placement
Local area
Immediate start
Flexible hours
Cardinal Health
Frankfort, KY
6 hours ago
Return-to-Work Specialist
$48k - $63k
...Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Return-to-Work Specialist Return to Work Specialist Apply your medical/clinical or rehabilitation knowledge and experience to assist in the...
Full time
Remote work
Flexible hours
Sedgwick
Frankfort, KY
17 hours ago
CS Specialist I - Customer Service Center
...responding to, and resolving customer requests related to bank products and services in the Bank’s call center. The Customer Service Specialist I is often the primary interaction a customer may have with the bank and provides professional and courteous customer support...
Full time
Bank staff
Work at office
Remote work
Monday to Friday
Flexible hours
WesBanco
Frankfort, KY
1 day ago
Hierarchical Condition Category (HCC) Coding Specialist
$27.02 per hour
...CERTIFICATIONS Required (any of the following) Certified Professional Coder (CPC) Certified Risk Coder (CRC) Certified Coding Specialist (CCS) Registered Health Information Technician (RHIT) Preferred ~ None SKILLS Critical Thinking Attention to...
For contractors
Work at office
Local area
Remote work
Flexible hours
Highmark Health
Frankfort, KY
17 hours ago
ITSM Specialist
...flexible, configurable, and scalable platform that addresses lenders and borrowers ever-evolving needs. Job Overview: ITSM Specialist The ITSM Specialist plays a critical role in supporting and coordinating the software development lifecycle through core IT service...
Flexible hours
defi AUTO LLC
Frankfort, KY
4 days ago
Annual Fund Coordinator
...develop, and implement annual fundraising campaigns to support the university's programs and initiatives.Create compelling fundraising appeals and materials to engage donors and alumni.Coordinate online and offline fundraising efforts, including email campaigns, direct mail...
Full time
Work at office
Work visa
Weekend work
Afternoon shift
Kentucky State University
Frankfort, KY
4 days ago
Cognitive Performance Specialist
$70k - $78k
...strengths and interests in building our team and delivering for clients. Description SCT seeks an experienced Cognitive Performance Specialist (CPS) to support a proposal for Army National Guard Holistic Health and Fitness (H2F) Performance Team services. The CPS supports...
Full time
Temporary work
For contractors
Remote work
Flexible hours
Afternoon shift
SCT
Frankfort, KY
4 days ago
Maintenance Specialist - Electrical - 2nd or 3rd Shift
...add, retrieve and close out completed work orders. Shows willingness and participates in training classes intended to improve the specialists’ knowledge and ability to troubleshoot, maintain, and assist in improvement opportunities related to the operations at this...
Work at office
Relocation
Shift work
Night shift
Weekend work
Afternoon shift
Suntory Global Spirits
Frankfort, KY
5 days ago
Injury Prevention Specialist
$63k - $72k
...Injury Prevention Specialist (IPS) SCT is a firm that partners and collaborates with our clients to deliver results and navigate complex challenges. We bring specialized expertise in strategic planning, organizational effectiveness, data analytics, talent management...
Full time
Temporary work
Remote work
Flexible hours
Afternoon shift
SCT
Frankfort, KY
1 day ago
Staffing Specialist
Job Description Surge Staffing is seeking a Talent Advisor with high energy, work ethic, good attitude, personality with a good phone voice. This is a permanent, full-time internal position with Surge Staffing. Considerations will be made immediately. Entry Level Customer...
Permanent employment
Full time
Temporary work
Work experience placement
Work at office
Immediate start
SURGE Staffing
Frankfort, KY
3 days ago
Delivery Specialist
The Delivery Specialist will maintain and operate store vehicles to deliver parts and/or products to professional customers in a safe and efficient manner. This position will also collect money on C.O.D. deliveries and pick up customer returns. Bilingual candidates encouraged...
Local area
Immediate start
Flexible hours
O'Reilly Auto Parts
Frankfort, KY
1 day ago
Project Specialist - Public Assistance
..., Inc., a national multi-disciplinary engineering and Emergency Management consulting firm is seeking several qualified Project Specialists/Analysts to assist clients in obtaining FEMA related Public Assistance services and other related duties as required. (Local candidates...
Work at office
Local area
CDR Companies
Frankfort, KY
5 days ago
Supervisory Privacy Specialist
...--HUD's Office of Administration is the place for you! The official title of this position is Supervisory Government Information Specialist. As a Supervisory Privacy Specialist, you will: Plan, manage, organize and supervise all operations and activities of the Privacy...
Full time
Temporary work
Part time
Work experience placement
Work at office
U.S. Department of Housing and Urban Development
Frankfort, KY
4 days ago
Quality Technician
$19.25 - $20.25 per hour
Forklift Material HandlerWe are seeking a reliable and safety-focused Forklift Material Handler to join our team. This position will be responsible for operating both sit-down and stand-up forklifts to move, load, unload, store, and distribute materials throughout the ...
Contract work
Temporary work
Aerotek
Frankfort, KY
4 days ago
Forward Deployed Specialist, Physical AI
$126k - $158k
...Want to work with highly motivated individuals on high-performance teams? Join WWT today! Job Summary The Forward Deployed Specialist is the builder on the ground for WWT's Physical AI engagements, from the first prototype through a pilot running in the customer'...
Full time
Flexible hours
Shift work
World Wide Technology
Frankfort, KY
4 days ago
Ophthalmologist
$300k
Position: Ophthalmologist Location: Frankfort & Lexington, KY Position Overview: A well-established ophthalmology-optometry practice in Kentucky is seeking a Board Eligible/Board Certified Ophthalmologist to join their growing team. The practice offers immediate...
Private practice
Work at office
Immediate start
Relocation package
Flexible hours
Protouch Staffing
Frankfort, KY
4 days ago
Senior Post-Award Associate
TITLE: Senior Post-Award AssociateDEPARTMENT: Post-Award DepartmentREPORTS TO: Director of Sponsored ProgramsCLASSIFICATION: Staff - 12 MonthsEFFECTIVE DATE: TBDSTANDARD WORK HOURS: 37.5 hours per weekLOCATION: On-Site Main CampusEMPLOYMENT STATUS: Full-TimeEMPLOYMENT CLASSIFICATION...
Contract work
Work at office
Kentucky State University
Frankfort, KY
1 day ago
Documentation Specialist
$36.06 - $40.87 per hour
Assists with the development of various documentation products in support of assigned program/project system. Collaborates with appropriate team members to develop required documentation materials (end-user manuals, technical documents, graphics, etc.). Ensures all developed...
Contract work
Work at office
ASM Research, An Accenture Federal Services Company
Frankfort, KY
1 day ago
Patient Safety Associate I (Drug Safety Associate I)
About Parexel Parexel is a leading global clinical development partner delivering insights driven clinical and consulting solutions to the life sciences industry. With 22,000+ employees worldwide, we partner with biopharmaceutical companies and research sites to design...
Remote work
Work from home
Worldwide
Flexible hours
PAREXEL
Frankfort, KY
6 hours ago
Incident Response Coordinator
The Incident Response Coordinator supports the end‑to‑end response to IT incidents and service disruptions, helping restore normal operations quickly and reduce impact on mission‑critical systems. The role serves as the central coordination point for incident response ...
Contract work
Work experience placement
Work at office
Shift work
ASM Research, An Accenture Federal Services Company
Frankfort, KY
3 days ago
Technical Solutions Architect I -- Computer Vision Specialist
$110k - $138k
...work with highly motivated individuals on high-performance teams? Join WWT today! What will you be doing? The Computer Vision Specialist is a member of WWT’s Global Solutions & Architecture team, part of AI & Data Solutions, focused on computer vision and the...
Full time
Work experience placement
Remote work
Flexible hours
Shift work
World Wide Technology
Frankfort, KY
2 days ago
Customer Service Representative
...selling on each transaction. Clean and merchandise sales areas (deli, sales floor, and cooler) to ensure product is always visually appealing and available for our customers. Clean floors, restrooms, parking lots, and all other areas around the store. Practice safe...
Seasonal work
Local area
Shift work
Night shift
Weekend work
FiveStar
Frankfort, KY
17 hours ago
Incident Response Coordinator, Senior
The Incident Response Coordinator, Senior leads tactical coordination of complex IT incidents to minimize mission impact. The role facilitates disciplined war rooms, enforces cadence and runbooks, drives cross-team collaboration, and provides executive-ready communications...
Contract work
Work experience placement
Work at office
Shift work
ASM Research, An Accenture Federal Services Company
Frankfort, KY
1 day ago
Online Order Filling Team Associate
Online Order Filling Team Associate WM Supercenter #720 301 Leonardwood Rd Frankfort, KY 40601-6531 CP-720-9038 $14.00 - $27.00/hr* Full time Shift may start between 8:00am - 4:00pm Role Summary Online Order Filling associates have one focus: to fill and dispense...
Hourly pay
Minimum wage
Full time
Temporary work
Part time
Shift work
Weekend work
Afternoon shift
Walmart
Frankfort, KY
1 day ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Appeals & Grievances Specialist. Be the first to apply!