Appeals & Grievances Specialist - Health Plan
CVS Health
CVS Health is seeking a detail-oriented Appeals Specialist to manage intake, research and resolution of member and provider appeals, complaints, and grievances. You will coordinate responses across multiple teams, verify eligibility and benefit details, and ensure timely communication to members. Strong analytical and regulatory knowledge is required to identify trends and support quality service. The role emphasizes accuracy, collaboration, and the ability to work in a fast-paced environment #J-18808-Ljbffr CVS Health
$83.1k - $120.36k
...Position Summary: The Appeals & Grievances (A&G) unit manages Healthfirst member... ...manner. The A&G Clinical Specialist is the subject matter expert... .... Manages all Department of Health (DOH) and executive complaints... ...HF’s internal health plans policies and procedures to frame...Health InsuranceContract workTemporary workWork experience placementLocal areaRemote work- ...payment platforms, and member engagement solutions, we help health plans deliver high-quality benefits to their members that address the... ...or scheduled full hearing tests daily for the hearing aid specialist or audiologist that works in the center Promote and sell non...Health InsuranceWork at officeImmediate startFlexible hours
$136.24k
...Prepares required documentation records such as: Project Execution Plans (PXPs), conforming bid documents from addenda, status reports... ...Quality Control (QA/QC) reporting for project sites. Works with Health & Safety professionals to identify Definable Features of Work (...Health InsuranceContract workWork experience placementFor subcontractorH1b- ...Title is seeking an entry-level **Title Specialist** to join our team. In this role, you'll... ...medical, prescriptions, dental and vision plans* 401(k) plan with a discretionary company... ...holidays per year* Flexible spending account* Health savings account (available to High...Health InsuranceFull timeWork at officeRemote workMonday to FridayFlexible hours
$27.02 per hour
...JOB SUMMARY This job will deliver value to the Health Plan, and its beneficiaries enrolled in Risk Adjusted government programs such... ...Coder (CPC) Certified Risk Coder (CRC) Certified Coding Specialist (CCS) Registered Health Information Technician (RHIT) Preferred...Health InsuranceFor contractorsWork at officeLocal areaRemote workFlexible hours- ...Coastal Engineering Practice, we are looking for a Bridge Hydraulics Specialist to join our team. You are going to work closely with a team of... ...and sealing bridge hydraulic reports and bridge hydraulics plan sheets.· Advanced proficiency with HEC-RAS (1D/2D), HEC-HMS, HY...Health InsuranceFull timeLocal areaWork from homeFlexible hours
- ...Permanent Description & Requirements Veterinary Internal Medicine Specialist Full-Time opportunity in Palm Beach Gardens, FL AtPet Emergency... ...monitoring, CT, and fluoroscopy. As part of Ethos Veterinary Health, your voice, growth, and expertise truly matter. Location...Health InsurancePermanent employmentFull timeTemporary work
- ...Corrections Working Title: PLACEMENT & TRANSITION SPECIALIST ADVERTISING TITLE: Placement & Transition... ..., developing personalized education plans, providing counseling, and fostering a... ...sick leave, and holidays. Comprehensive health insurance and life insurance with accidental...Health InsuranceTemporary workWork experience placementH1bWork at officeRemote work
- ...Package: Competitive Wages & Paid Time Off Stock Purchase Plan & 401k with Employer Contributions Starting Day One Medical,... ...with Optional Flexible Spending Account (FSA) Team Member Health/Wellbeing Programs Tuition Educational Assistance Programs...Health InsuranceLocal areaImmediate startFlexible hours
- ...Pizza is an Equal Opportunity and E-Verify Employer. Reasonable accommodations will be provided as required by law. Supplemental pay ~ Tips Benefits ~ Flexible schedule ~ Health insurance ~401(k) ~ Employee discount ~ Paid training...Health InsuranceFull timePart timeCasual workFlexible hours
$50k - $100k
...Full-time employees are offered: ~ Health Insurance ~ Health Savings Account ~... ...Employee Assistance Program (EAP) ~401(k) Plan ~ Paid Time Off ~ Paid Holidays ~... ...POSITION SUMMARY The Employment Specialist (ES) is responsible for creating and implementing...Health InsuranceHourly payWeekly payFull timePart timeWork at officeLocal areaFlexible hoursWeekend workAfternoon shift1 day per week$68k - $113.4k
...firms.About the RoleThe Segment Revenue Specialist blends strategic thinking with executional... ...strategyPresent GTM strategies, launch plans, and business results to senior... ...balance across the organization. We offer an appealing working prospect for our people. With numerous...Full timeWork at officeLocal areaImmediate startWork from homeFlexible hours$37.58k
...: Department of Corrections Working Title: PAROLE/PROBATION SPECIALIST Pay Plan: Career Service Position Number: 70007917 Salary: $37,582.22... ...Benefits Paid vacation, sick leave, and holidays. Comprehensive health insurance and life insurance with accidental death and...Health InsuranceWork experience placementWork at officeRemote workTrial period$50k - $100k
...Full-time employees are offered: ~ Health Insurance ~ Health Savings Account ~... ...Employee Assistance Program (EAP) ~401(k) Plan ~ Paid Time Off ~ Paid Holidays ~... ...POSITION SUMMARY The Youth Employment Specialist is a direct service provider to all...Health InsuranceHourly payWeekly payFull timePart timeWork at officeLocal areaFlexible hoursWeekend workAfternoon shift- ...Overview Due to growth we are adding an Intake Specialist to our team! Under direction from the Assoc. Manager, Patient Support Services... ...can you expect from Lumicera? Top of the industry benefits for Health, Dental, and Vision insurance 20 days paid time off 4 weeks paid...Health InsuranceRemote workFlexible hoursShift work
- ...Delivery Specialist The Delivery Specialist will maintain and operate store vehicles to deliver... ...Wages & Paid Time Off Stock Purchase Plan & 401k with Employer Contributions... ...Flexible Spending Account (FSA) Team Member Health/Wellbeing Programs Tuition Educational...Health InsuranceLocal areaImmediate startRemote workFlexible hours
- ...promoting and executing consistent and compliant operating conditions. Provides fresh and appealing products, courteous, knowledgeable and prompt service. Executes merchandising plans as outlined in department planners, toolkits or event packs being mindful of...Work at officeLocal areaShift workNight shift
- ...potential. Job Title Seafood Specialist Location: Retail Grocery Location... ...manager with implementing plans to ensure customer confidence... ..., providing fresh and appealing product, providing courteous,... ...aspects of federal and state health, safety and sanitation codes....Immediate start
$16 - $19 per hour
...keep them continuously informed. Review for accuracy of prescribed treatment regimen prior to submission of authorization. Facilitate appeals process between the patient, physician and insurance company by requesting denial information and facilitates obtaining the denial...Work at office- Job-ID29459518Reference26-28576 EEO: “Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of - Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.”
- ...Healthcare: Career growth and advancement potential Great benefits such as: Health, Dental, Vision, Life, & Disability Insurance Tuition Reimbursement Paid Personal Leave and Paid Holidays 403b Retirement Plan (matches one to one of employee contribution for the first 3%, then...Full timeWork experience placementImmediate startShift work
- ...consider a career in Advisory.KPMG is currently seeking a Lead Specialist, Oracle GL/AP to join our Managed Services practice.... ...build of product specific functional specifications; support the planning, preparation and execution of future releases; provide specialized...H1bLocal area
- ...Integrated Supply Chain (ISC) division is seeking a Principal Sourcing Specialist. In this position, you will be responsible for managing... ...• Participates in sourcing data analysis, forecasting and planning • Develops new sources of supply and monitors ongoing supplier...Contract workFor contractorsWork at officeLocal areaRelocation
- Requisition ID: 66622 Title:Leave Specialist IIIArthrex Human Resources team in SWFL is currently recruiting for a Leave Specialist III to... ....Participates in determining objectives of assignments. Plans, schedules, and arranges own activities and coordinates activities...Temporary work
- ...1 floating holiday; and Veteran's Day paid double for employees whose DD214 is on file 4 traditional and 2 basic coverage health insurance plans to choose from Employer contribution monthly on healthcare plans Traditional and Roth 401k options with company match Company...Health InsuranceTemporary workMonday to ThursdayDay shiftAfternoon shift
$48k - $63k
...Financial Services & Insurance Return-to-Work Specialist Return to Work Specialist Apply... ..., restrictions, and rehabilitation plans. Work in the best of both worlds - a rewarding career making an impact on the health and lives of others, and a remote work environment...Full timeRemote workFlexible hours- ...needs.Maintains all assigned ancillary and department areas and corridors in a clean neat and sanitary manner, to protect safety and health of others and in compliance with accurate preventative maintenance procedures as outlined in department policy.Inspects and uses...
- Sedgwick in Florida is seeking an Utilization Review Coordinator to support clinical staff by assigning UR requests, verifying data, and entering information into the appropriate systems. This role emphasizes accuracy, teamwork, and timely processing in a busy healthcare...
- Thimble Alterations LLC is seeking experienced bridal alteration professionals to join a network of independent contractors. You will alter bridal and wedding wear, perform fittings, and provide timely communication to clients, all from your own workspace. Ideal candidates...For contractorsRemote work
- Complexity of Work: Requires critical thinking skills, effective communication skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action. Required Work Experience: Three (3) years...Work experience placement
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