Grievance/Appeals Analyst I - Indianapolis

This is an entry level position in the Enterprise Grievance & Appeals Department that reviews, · analyzes and processes non-complex pre-service and post-service grievances and appeals requests from customer types (i.e. member, provider, regulatory and third party) and multiple pr ...

The Grievance/Appeals Analyst I is an entry level position in the Enterprise Grievance & Appeals Department that reviews analyzes and processes non-complex pre service and post service grievances and appeals requests from customer types (i.e. member provider regulatory and third ...

+This is an entry level position in the Enterprise Grievance & Appeals Department that reviews, analyzes and processes non-complex pre service and post service grievances and appeals requests from customer types (i.e. member, provider, regulatory and third party) and multiple pro ...

The Grievance & Appeals Specialist II reviews appeals submitted by Medicaid and Medicare providers and all future providers contracted with CareSource. · Prepare the appeals for clinical review · Review submitted appeals daily for validation of the appeal · ...

This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. · Ensures accurate adjudication of claims by translating medical policies into effective reimbursement criteria. · ...

+This role enables associates to work virtually full-time with maximum flexibility and autonomy. Ensures accurate adjudication of claims by translating medical policies into effective and accurate reimbursement criteria. · +We offer a range of market-competitive total rewards tha ...

Nurse Appeals is responsible for investigating and processing medical necessity appeals requests from members and providers. The role involves conducting investigations and reviews of member grievances and Quality of Care cases. It requires a HS diploma or equivalent and a minimu ...

+This role enables associates to work virtually full-time, with the maximum flexibility and autonomy. · +Conducts investigations and reviews of member and provider medical necessity appeals. · Reviews prospective, inpatient, or retrospective medical records of denied services for ...

This role enables associates to work virtually full-time with maximum flexibility and autonomy investigating medical necessity appeals requests from members. · Conducts investigations and reviews of member and provider medical necessity appeals. · Reviews prospective inpatient or ...

This position will assist in managing SPG's real property tax assessment appeal/litigation practice. · Collecting internal and external financial related information. · Performing assignment specific financial data collection and valuation analysis. · ...

This role requires associates to be in-office three days a week while providing flexibility to support productivity and work-life balance. · Interpret existing policies and develop new policies based on changes in the healthcare or medical arena. · Lead, develop, direct and imple ...

IT Project Analyst needs 3+ years IT project analysis experience. The position requires driving engagement and team building, fostering a positive team culture preferably within a technical or data science environment. · Previous experience in driving engagement and team building ...

The Medical Director relies on medical background and reviews health claims. · The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. · ...

This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. · ...

This position processes the correction or refund of property taxes, including applying and removing deductions, credits, abatements, and exemptions. · Assists Refund and Correction Manager with processing the correction or refund of property taxes. · ...

+Job summary · LTSS Service Coordinator (Case Manager) is responsible for conducting service coordination functions for a defined caseload of individuals in the IN PathWays for Aging program. · +Facilitates the Person Centered Planning process that documents the member's preferen ...

This is a field-based role that enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires. The Service Coordinator (Case Manager) conducts service coordination functions for a defined caseload of individuals in ...

This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires. · ...

The LTSS Service Coordinator (Case Manager) is responsible for conducting service coordination functions for a defined caseload of individuals in the IN PathWays for Aging program. · ...

The LTSS Service Coordinator (Case Manager) is responsible for conducting service coordination functions for a defined caseload of individuals in the IN PathWays for Aging program. · ...