Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

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

Vacancy posted 12 hours ago
Similar jobs that could be interesting for youBased on the Appeals & Grievances Specialist - Health Plan in Tallahassee, FL vacancy
  • $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 Insurance
    Contract work
    Temporary work
    Work experience placement
    Local area
    Remote work

    Healthfirst

    Tallahassee, FL
    4 days ago
  •  ...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 Insurance
    Work at office
    Immediate start
    Flexible hours

    NationsBenefits, LLC

    Tallahassee, FL
    4 days ago
  • $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 Insurance
    Contract work
    Work experience placement
    For subcontractor
    H1b

    CDM Smith

    Tallahassee, FL
    5 days ago
  •  ...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 Insurance
    Full time
    Work at office
    Remote work
    Monday to Friday
    Flexible hours

    Old Republic Title

    Tallahassee, FL
    5 days ago
  • $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 Insurance
    For contractors
    Work at office
    Local area
    Remote work
    Flexible hours

    Highmark Health

    Tallahassee, FL
    2 days ago
  •  ...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 Insurance
    Full time
    Local area
    Work from home
    Flexible hours

    COWI

    Tallahassee, FL
    1 day ago
  •  ...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 Insurance
    Permanent employment
    Full time
    Temporary work

    National Veterinary Associates

    Tallahassee, FL
    4 days ago
  •  ...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 Insurance
    Temporary work
    Work experience placement
    H1b
    Work at office
    Remote work

    Fldocjobs

    Tallahassee, FL
    3 days ago
  •  ...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 Insurance
    Local area
    Immediate start
    Flexible hours

    O'Reilly Auto Parts

    Tallahassee, FL
    2 days ago
  •  ...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 Insurance
    Full time
    Part time
    Casual work
    Flexible hours

    Piesanos Stone Fired Pizza

    Tallahassee, FL
    1 day ago
  • $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 Insurance
    Hourly pay
    Weekly pay
    Full time
    Part time
    Work at office
    Local area
    Flexible hours
    Weekend work
    Afternoon shift
    1 day per week

    EmployU

    Tallahassee, FL
    5 days ago
  • $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 time
    Work at office
    Local area
    Immediate start
    Work from home
    Flexible hours

    RELX Group

    Tallahassee, FL
    1 day ago
  • $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 Insurance
    Work experience placement
    Work at office
    Remote work
    Trial period

    Florida

    Tallahassee, FL
    1 day ago
  • $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 Insurance
    Hourly pay
    Weekly pay
    Full time
    Part time
    Work at office
    Local area
    Flexible hours
    Weekend work
    Afternoon shift

    EmployU

    Tallahassee, FL
    3 days ago
  •  ...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 Insurance
    Remote work
    Flexible hours
    Shift work

    Lumicera

    Tallahassee, FL
    2 days ago
  •  ...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 Insurance
    Local area
    Immediate start
    Remote work
    Flexible hours

    O'Reilly Auto Parts

    Tallahassee, FL
    3 days ago
  •  ...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 office
    Local area
    Shift work
    Night shift

    The Winn-Dixie Company

    Tallahassee, FL
    3 days ago
  •  ...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

    Fresco y Más

    Tallahassee, FL
    5 days ago
  • $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

    Cinq Group LLC

    Tallahassee, FL
    4 days ago
  • 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.”

    Mindlance

    Tallahassee, FL
    1 day ago
  •  ...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 time
    Work experience placement
    Immediate start
    Shift work

    SMA Healthcare

    Tallahassee, FL
    2 days ago
  •  ...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... 
    H1b
    Local area

    KPMG

    Tallahassee, FL
    4 days ago
  •  ...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 work
    For contractors
    Work at office
    Local area
    Relocation

    NextEra Energy

    Tallahassee, FL
    5 days ago
  • 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

    Arthrex

    Tallahassee, FL
    1 day ago
  •  ...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 Insurance
    Temporary work
    Monday to Thursday
    Day shift
    Afternoon shift

    Diamondback Firearms

    Tallahassee, FL
    1 day ago
  • $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 time
    Remote work
    Flexible hours

    Sedgwick

    Tallahassee, FL
    3 days ago
  •  ...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... 

    Aramark

    Tallahassee, FL
    4 days ago
  • 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...

    Sedgwick

    Tallahassee, FL
    6 hours ago
  • 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 contractors
    Remote work

    Thimble Alterations LLC

    Tallahassee, FL
    4 days ago
  • 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

    Memorial Health Care System

    Tallahassee, FL
    4 days ago

Do you want to receive more vacancies?

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