Grievance & Appeals Analyst I - Compliance & Resolution
Solis Health Plans
Solis Health Plans is hiring for the Grievance and Appeals Analyst I position based in New York. This role involves reviewing member grievances and appeals, ensuring compliance with CMS and NCQA guidelines. Ideal candidates will have at least 2 years of experience in managed care or claims processing. The position requires strong analytical skills and the ability to document findings meticulously. Applicants should also be proficient in Microsoft Office and have solid communication abilities. #J-18808-Ljbffr Solis Health Plans
- Position Summary The Grievance and Appeals Analyst I is responsible for the review, investigation, and resolution of member grievances and appeals within a managed‑care health... ...ensures all activities are conducted in compliance with regulatory requirements, including those...SuggestedContract workWork at office
- ...for Career Enhancement is seeking a full-time Insurance AR Resolution Analyst for CVS Health in New York. You will perform advanced analysis... ...cycle management and maximize collections while ensuring compliance with regulations. The ideal candidate should possess strong...SuggestedFull time
- A healthcare solutions provider is seeking a Registered Nurse for Claims & Appeals Review. This remote role supports compliance and quality assurance in appeal reviews. Candidates should have a Bachelor's degree in healthcare and valid RN license in Florida. Key responsibilities...SuggestedRemote job
- ...to the bank while maintaining quality service and controlling compliance with AML, OFAC, and BSA policies. Aids with research requests... ...surrounding wire transfers. Investigate, close, and provide error resolution on Consumer International Dodd‑Frank transactions. Complete...Suggested
- Certified Epic Resolute HB App Analyst page is loaded## Certified Epic Resolute HB App Analystlocations: Remotetime type: Full timeposted on: Posted Todayjob requisition id: JR107194Ranked #1 for Safety, Quality and Patient Satisfaction, Jupiter Medical Center is the leading...SuggestedWork at office
$46.99k - $122.4k
Position Summary The Senior Business Analyst supports execution and coordination of PBM,... ...and organization of evidence for audit, compliance, or regulatory follow‑up needs Data & Analytical... ..., scope, or required fields and support resolution of identified differences Support...Remote jobFull timeLocal area- ADP is hiring a Deal Desk Analyst - Small Business Services (SBS) within our Commercial... ...and deal level that ensures accuracy and compliance with Sales and Service customer onboarding... ...and proactively drive issues to resolution. Knowledge of HR and Payroll industry tools...Local area
- ...action; serves as a source of expert advice, influences change; frames information in a broader context. Identifies and leads problem resolution for project/program complex requirements related issues at all levels. Requirements Undergraduate degree or technical certificate...
- ...collaborative environment. Join our Technology Team as an IT Risk and Compliance Analyst located in our Miramar office. We are seeking a professional... ...with IT audits, findings, and tracking and remediating to resolution Working knowledge of cloud technologies (any of these, Azure...Work experience placementWork at office
- ...needs, intervention planning, reporting enhancements, and issue resolution. Stay current on healthcare analytics, Risk Adjustment trends,... ...solutions on ad-hoc requests with little oversight by senior analysts. To Be Considered For This Position, You Must Have Bachelor’s...Live inRemote work
$81k - $155k
...mitigation efforts. Own, execute and drive all incidents to resolution using facilitation, organization and time‑management skills.... ...set by your manager. Employees are responsible for maintaining compliance with hybrid work policies. Scheduled Weekly Hours 40 Equal Employment...Temporary workPart timeWork experience placementWork at officeWork from homeShift work3 days per week$1,000 per month
...one of our clients Product Implementation Analyst - UKG Ready AlphaStaffHCM is seeking a... ...for time and attendance issues. Follow resolution and escalation procedures based on problem... ...our clients improve talent management, compliance, employee benefits, and HR technology by...Work experience placementWork at officeLocal areaRemote workHome office- ...Engage with Risk Subject Matter Experts (SMEs) such as BSA/AML, Compliance, Information Security, Technology, Third Party Risk, and Fraud... ...standards, and elevate findings or inconsistencies for resolution as needed. Monitor control performance data to ensure controls...
$118.8k - $178.2k
...to hire a Senior Litigation Analyst to join our Legal team. We are... ...prompt, efficient handling of appeals. Litigation Expense... ...level billing trend analysis, compliance information, and a firm’s cooperation... ...individuals and assist in problem resolution. Provide customer assistance,...Temporary workWork at officeRemote work3 days per week- ...aide in the detection of possible money laundering, terrorist financing, and fraud using risk-based approach methods while ensuring compliance with the Bank's established BSA/AML program. ESSENTIAL DUTIES AND RESPONSIBILITIES Other duties and special projects may be...
- ...processes. Experience responding to external audits, CMS inquiries, compliance requests, and cross-functional operational initiatives.... ...ability to work across operational areas (e.g., Clinical Claims, Appeals, Provider Enrollment, EDI, Contact Centers, and other business...
- ...BankUnited is seeking a motivated, self-starting Analyst to join the Third Party Risk Management team. In this highly visible role,... ...parties. Influences third parties and business partners to ensure compliance with risk management policies, to include driving the...Work experience placement
- Job Description The Surety Division of Bankers Insurance Company offers unsurpassed service and quality to our agents. We are one of the largest providers of the Bail Bond industry and one of the fastest-growing providers of Contract and Commercial Bonds to businesses....Contract workRemote work
- ...will be responsible for the monitoring of merchant activity via report analysis, gateway monitoring, and outbound calling to verify compliance of terms of the merchants processing agreement, holding questionable batches until an investigation can be completed, and...Work at office
$63.75k
...Reporting to the Senior Manager of Corporate Insurance at TKO, the Risk Analyst role is responsible for providing operational and analytical support in the strategic development of TKO’s Risk Management program. This role will assist in the planning, implementation and...Local area- Blue Cross and Blue Shield of Nebraska is seeking a Healthcare Analytics professional to support Risk Adjustment Programs by analyzing healthcare data and delivering actionable reports and forecasts. The role focuses on measuring program performance, ROI, and risk score...Remote work
- ...experienced in-house SAP S/4HANA Functional Analyst to support, configure, and enhance SAP... ...solutions aligned with operational and compliance needs. Workflow & Process Automation... ...audit requirements. Assist with issue resolution, root cause analysis, and ongoing production...
- ...between business units and support functions including Risk, Compliance, Operations, Technology, and Finance. While the position does... ...findings and responses across LOBs for leadership review and resolution tracking. Engage with Compliance and Risk teams to address regulatory...Work at office
- ...and analytical Clinical Coding Analyst to join our team and take on... ...accuracy, completeness, and compliance of coding practices, and ensure... ...evaluate coding denials and appeals. Compile and prepare... ...Analyst and contribute to the resolution of coding-related denials, ensuring...Local area
$78k - $82k
...accommodation or an alternative application process. Senior Encounters Analyst Full Time Staff South Florida Community Care Network, LLC,... ...Position Summary: Make an Impact on Healthcare Data, Compliance, and Strategy Community Care Plan is seeking a Senior Encounters...Full timeRemote work- Pyramid Consulting, Inc. is assisting with a Contract Analyst role in Lake Mary, FL. The position is a 3+ month contract with hybrid... ...pricing, membership agreements, and supplier contracts to ensure compliance and accurate pricing. The ideal candidate has an Associate...Contract workWork at office2 days per week
$70k - $90k
...accommodation or an alternative application process. Value Based Care Analyst Staff South Florida Community Care Network, LLC, Sunrise, FL,... ..., equity, and inclusion. Background Screening Notice: In compliance with Florida law, candidates selected for this position must...Remote work- TechDigital Group in New York seeks a Wealth Management Reconciliation Analyst to manage account reconciliation breaks. The analyst will conduct transaction-level analysis and resolve discrepancies effectively. Key responsibilities include investigating complex reconciliation...
- ...world. The Role We are looking for a Senior Business Operations Analyst to join our growing Collections Center of Excellence (CCoE)... ...Technology teams to identify gaps in workflows, policies, regulatory compliance, and execution processes related to delinquent customer...Work at officeRemote work
- ...system‑driven, data‑populated forms (e.g., deeds, policy jackets, schedules, affidavits, settlement documents) to ensure accuracy, compliance, and proper workflow execution. Job Responsibilities Lead troubleshooting for complex business application issues, often...Work experience placement
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Grievance & Appeals Analyst I - Compliance & Resolution. Be the first to apply!
- law enforcement response team analyst Florida, NY
- bsa analyst Florida, NY
- command center analyst Florida, NY
- senior analyst Florida, NY
- behavioral analyst Florida, NY
- corporate actions analyst Florida, NY
- revenue cycle analyst Florida, NY
- health analyst Florida, NY
- incentive compensation analyst Florida, NY
- agriculture analyst Florida, NY

