Senior Healthcare Appeals & Complaints Analyst
CVS Health
CVS Health is seeking a Complaints & Appeals Analyst to review, investigate, and resolve member complaints, appeals, and grievances. The role requires analyzing benefit information and policy details to determine accurate outcomes, while collaborating with internal partners to ensure timely, compliant resolutions. The position emphasizes strong analytical abilities, problem-solving, and communication, with a focus on adherence to policies and regulatory requirements. #J-18808-Ljbffr CVS Health
Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Senior Healthcare Appeals & Complaints Analyst in Columbus, OH vacancy
- CVS Health in Columbus, OH is seeking a Complaints & Appeals Analyst to resolve member complaints, appeals, and grievances. You will review case documentation, analyze benefit and policy information, and ensure timely, accurate determinations in line with procedures and...SeniorComplaints
- ...outcomes, liability and casualty claims, and collaborating with legal teams. The role covers case management, reporting, and on-site insurance liaison functions, with responsibilities spanning patient complaints, unusual occurrences, litigation #J-18808-Ljbffr OhioHealthSeniorComplaints
- ...for OPG to make full-time Responsibilities And Duties: Patient Complaint/Claims management 35% Meets with patients, families, visitors,... ...Nurse - Ohio Board of Nursing Additional Job Description: Healthcare operations; proven complaint/grievance handling & conflict resolution...SeniorComplaintsFull timeWork at officeLocal areaShift work
$26.39 - $63.13 per hour
...The Health Operations Senior Analyst supports the accuracy and effectiveness of healthcare claims editing and auditing processes. This role reviews edit and audit... ...the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation...SeniorComplaintsHourly payFull timeLive inWork at officeLocal areaAccenture Global
Columbus, OH1 day ago$18.5 - $35.29 per hour
...information necessary to resolve member complaints, appeals, and grievances. Reviews case... ...Brief Overview The Complaints & Appeals Analyst is responsible for reviewing, investigating... ...Preferred Qualifications Experience in healthcare, insurance, claims, customer service,...SeniorComplaintsHourly payFull timeWork experience placementWork at officeLocal area- ...Why You Should Work With UsAs a Sinceri Senior Living company, we are a fun loving, employee... ...for our 7th Year in a row. Create your healthcare career with us and learn about all the... ...a family member and visitor concerns or complaints, documenting the issues and actions...SeniorComplaintsShift work
Sinceri Senior Living
Columbus, OH2 days ago - Molina Healthcare, Inc. is seeking a Senior Specialist, Member Engagement, to analyze and review our members' Value Added Benefits. This remote role requires Ohio residency and focuses on improving member engagement and retention while overseeing value-added benefits for...SeniorRemote job
- Elevance Health seeks a Behavioral Health Appeals Coordinator Senior to investigate and process the most complex grievances and appeals from members... ...an MS in social work or RN, with 4+ years in managed care/healthcare and active unrestricted licenses (LCSW/LMFT/LP C/RN). #J-...Senior
- ...states including Ohio. The role involves directing multiple projects, collaborating with clients, and applying analytic methods to healthcare data. The ideal candidate holds a health-related bachelor’s degree or RN, with at least 2 years of health data experience, #J-1...SeniorRemote workMonday to Friday
Advocate Health
Columbus, OH15 hours ago - ...experienced Epic skilled and certified Analyst in Epic Bridges &... ...the Epic Bridges & Rhapsody Senior Analyst will be responsible for... ...Minimum of 1 year of experience in Healthcare IT in an Epic Bridges &... ...(a) in response to a formal complaint or charge, (b) in furtherance...SeniorComplaintsWork experience placementLive inWork at officeLocal area3 days per week
Accenture
Columbus, OH3 days ago - ...Technology Medicare ConsultantJob Level: Senior Level Job Description: THIS IS WHAT YOU... ...and implement solutions that are Medicare complaint.You will be understanding the strategic... ...!Who holds consulting experience in US Healthcare Payer market!Who holds 2+ years’ experience...Complaints
Roljobs Technology Services
Columbus, OH1 day ago $78k - $156k
...AmericaTime Type: Full timeAbbott is a global healthcare leader that helps people live more fully... ...has an opportunity for a Business Analyst, Acute Care Contracting. The Business Analyst... ...and professional manner allowing senior management to efficiently and effectively...SeniorContract workWork experience placementShift workAbbott
Columbus, OH4 days ago$149k - $262k
...delivering extraordinary care.Nationwide Financial is seeking a Senior Actuary to join its Actuarial Enterprise Risk Management team.... ...individual location. The Act prohibits retaliation for reporting complaints or violations. For more information on the Iowa Smokefree Air...SeniorComplaintsFull timeTemporary workPart timeCasual workWork at officeRemote workNationwide
Columbus, OH3 days ago- ...read, analyze and comprehend journals, audit reports, regulations and legal documents.Ability to respond to common inquiries or complaints from employees, customers, regulatory agencies, or members of the business community. Ability to effectively present information...SeniorComplaints
- ...seeking a Medicaid/Medicare Program Integrity Analyst II for a REMOTE role based in Grove City, OH. You will evaluate leads, complaints, and investigations to verify potential... ..., supporting our mission to improve healthcare delivery. You will conduct independent reviews...ComplaintsRemote job
$70.35k - $150.4k
...experienced Epic skilled and certified Analyst in Epic Bridges & Rhapsody Core Responsibilities... ...: Minimum of 1 years experience in Healthcare IT in an Epic Bridges & Rhapsody Analyst... ...is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation...SeniorComplaintsFull timeWork experience placementLive inWork at officeLocal area3 days per weekAccenture Global
Columbus, OH1 day ago$73.28k - $109.92k
Behavioral Health Appeals Coordinator Senior Anticipated End Date: 2026-11-30 Position Title: Behavioral... ...of experience in a managed care/healthcare setting; or any combination of education... ...: Board Certified Behavior Analyst (BCBA) strongly preferred. Experience...SeniorTemporary workWork experience placementWork at officeLocal area2 days per week1 day per week$70.35k - $150.4k
...challenges. You are: An experienced Epic Cogito Admin Certified Analyst The Work: Depending on the client engagement, the Epic Cogito... ..., unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding,...SeniorComplaintsFull timeWork experience placementLive inWork at officeLocal area3 days per weekAccenture Global
Columbus, OH1 day ago- ## Senior Reimbursement AnalystApply: HYBRID - BLOM ADMINISTRATIVE CAMPUS: Full time: Posted... ...oversight of the Reimbursement Analyst daily work schedule including flow of information... ...with our legal vendor for Medicare Appeals. Working with OHA and CBSA facilities on...SeniorFull timeShift work
- ...Senior Reimbursement Analyst We are more than a health system. We are a belief system. We believe wellness... ...with our legal vendor for Medicare Appeals. Working with OHA and CBSA facilities... ...and want to be among the best in the healthcare industry Equal Employment...SeniorLocal area
$70k - $77k
Overview Medicaid/Medicare Program Integrity Analyst II - REMOTE The Medicaid/Medicare... ...performs evaluation and development of leads, complaints, and/or investigations to verify... ...expectations and contribute to improved healthcare delivery by identifying and eliminating...ComplaintsFor contractorsH2bH1bWork at officeLocal areaRemote workHome office- ...Corrects invalid allowed amounts in corresponding fee schedules Appeals underpayment errors with carriers Identifies & reports carrier... ...work, no gossiping or disparaging remarks, accepts work without complaint or provides reasons why assignment is unmanageable, asks and...ComplaintsFull timeShift workDay shift
$50 - $58 per hour
Senior IT Analyst - Telecom Expense Management job at Blue Star Partners LLC. Columbus, OH. Job Title: Senior IT Analyst - Telecom Expense... ...recommending corrective actions. Oversee SLA management and review appeals. Initiate RFPs/RFQs for network services, negotiate...SeniorContract workRemote workVisa sponsorshipMonday to Friday$69.4k - $99.2k
...skills and capabilities. Summary As a Senior Data Mining & Payment Integrity Analyst, you will design and develop data... ...billing. Using your expertise in healthcare reimbursement, regulations, and... ...and properly applied. Support the appeals, validation, and client services teams...SeniorFull timeContract workFlexible hours$132.5k - $338.3k
...Consulting: We collaborate with healthcare executives, leaders, and... ...- Epic and EHR Modernization Senior Manager, you will lead major... ...of managers, consultants, and analysts, and support offering and business... ...(a) in response to a formal complaint or charge, (b) in furtherance...SeniorComplaintsWork experience placementLive inWork at officeLocal areaWorldwideAccenture
Columbus, OH2 days ago$90.8k - $136.2k
Qualifications ~5+ years of related business analysis experience. ~ Genuine curiosity about how a technology solution provider and a partner reseller business actually operate, since you’ll need to build working expertise in both to write requirements that hold up ...SeniorFull timeFlexible hoursShift workWorld Wide Technology
Columbus, OH2 days ago$23 - $50 per hour
...designated smoking areas in which smoking is permitted at each individual location. The Act prohibits retaliation for reporting complaints or violations. For more information on the Iowa Smokefree Air Act, individuals may contact the Smokefree Air Act Helpline at 888-...ComplaintsHourly paySummer workInternshipSummer internshipNationwide Insurance and Financial Services
Columbus, OH3 days ago$96.4k - $144.6k
Qualifications Bachelor’s Degree; preferably in Business, IT, Accounting, MIS, Finance, or a related field. Minimum 6 years of functional experience with Oracle ERP Applications, including Oracle EBS R12 and/or Oracle Cloud Financials, with a focus on the Procure...SeniorFull timeRemote workFlexible hoursShift workWorld Wide Technology
Columbus, OH2 days ago- ...full-lifecycle technology programs for our healthcare clients. You are a proven delivery... ...and building trusted relationships with senior client executives.As an Accenture Senior... ...disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation...SeniorComplaintsWork experience placementLive inWork at officeLocal area
Accenture
Columbus, OH15 hours ago - ...Gifthealth, we're revolutionizing the way people experience healthcare by simplifying the process of managing prescriptions and... ...Position Overview We are looking for a meticulous Senior Data Analyst with exceptional skills in data analytics and reporting to...SeniorFull time
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Senior Healthcare Appeals & Complaints Analyst. Be the first to apply!
Related searches
- senior healthcare data analyst Columbus, OH
- entry level healthcare data analyst Columbus, OH
- healthcare analyst Columbus, OH
- senior vice president communications Columbus, OH
- senior specialist Columbus, OH
- senior advisor Columbus, OH
- senior tax associate Columbus, OH
- international tax senior Columbus, OH
- senior sales Columbus, OH
- senior director Columbus, OH