Appeals & Grievances Coordinator - Somerville, MA

Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. · We are pleased to offer competitive salaries and a benefits package with flexible work options, · This role will coordinate process investigate document all aspects of member complaints ...

This is an exciting place to be within the healthcare industry. · Handle a large volume of incoming grievances (both formal and informal) from receipt through resolution. · ...

+The Appeals and Grievance Coordinator will coordinate, process, and document all aspects of member appeals and grievances, · as well as provider appeals across all our product offerings (Commercial, Medicaid and Medicare). · ...

We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. · Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a ...

The incumbent will coordinate, process, and document all aspects of member appeals and grievances across our product offerings. Responsible for documenting and owning the life cycle of all member appeals and grievances and provider appeals. · ...

+Join our client's team as an Appeals & Grievances Coordinator and play a vital role in ensuring seamless resolution processes for member grievances and appeals within our innovative health plan. · +Manage a high volume of incoming grievances and appeals from initiation to resolu ...

Join our client's team as an Appeals & Grievances Coordinator and play a vital role in ensuring seamless resolution processes for member grievances and appeals within our innovative health plan. · Manage a high volume of incoming grievances and appeals from initiation to resoluti ...

The Duals Supervisor Appeals Grievances provides day-to-day supervision of a team of 4-6 appeals and grievance coordinators.• Facilitates regular bi-weekly one-on-one meetings and weekly team staff meetings with the Appeals and Grievances department. · • Identifies training needs ...

The Duals Supervisor, Appeals and Grievances provides day-to-day supervision of a team of 4-6 appeals and grievance coordinators and is ultimately responsible for the work product of this team and the Duals line of business. · The Supervisor oversees all aspects of the Appeal and ...

The Appeals Coordinator will coordinate, process, investigate, and document all aspects of member complaints across our Medicare line of business. · This role will be responsible for documenting and guiding the life cycle of all member appeals, · maintaining tracking information, ...

+ Job Summary · The role leads a team responsible for the processing of all Member Appeals and Grievances for Medicaid and Commercial product lines. · + Qualifications:Bachelor's Degree or the equivalent combination of training and experience required · + ...

The role leads a team responsible for the processing of all Member Appeals and Grievances for Medicaid and Commercial product lines. · Oversight includes appeal and grievance intake, investigation, and resolution. · Create systems and procedures for operating efficiency. · ...

This position provides direct supervision of internal, external and on call work crews. Oversees resources and personnel engaged in the operation maintenance and construction of Eversource Energy gas distribution systems. · The supervisor is responsible for preparing and executin ...

This role involves extracting knowledge and insights from data to investigate business/operational problems using various techniques. Key responsibilities include collecting and analyzing Medicare Advantage claims data to ensure timeliness accuracy compliance; reviewing tracking ...

+The Duals Supervisor, Appeals and Grievances provides day-to-day supervision of a team of 4-6 appeals and grievance coordinators... · +Bachelor's degree required or the equivalent combination of training and experience. · At least 5-7 years of health plan operations/appeals and ...

The Duals Supervisor, Appeals and Grievances provides day-to-day supervision of a team of 4-6 appeals and grievance coordinators. · The Supervisor oversees all aspects of the Appeal and Grievance processes in accordance with the Massachusetts Division of Insurance and Executive O ...

Responsible for extracting knowledge and insights from data in order to investigate business/operational problems through a range of data preparation, modeling, analysis, and/or visualization techniques. · This role is responsible for collecting monitoring and analyzing Medicare ...

The Appeals & Grievances Lead oversees the daily operations and performance of the Appeals & Grievances program. · Oversee workflow management to ensure cases are processed accurately and within required turnaround times · Ensure compliance with state and federal standards and in ...

We offer the Following:Premium Compensation · Great Benefits Package · Professional Growth & Stability · Benefits:401(k) · Dental insurance · Health insurance · Paid time off · Vision insurance ...

The Quality Investigations Specialist is an important part of the Quality team responsible for conducting timely and thorough investigations into grievances, · complaints and alleged human rights violations.Collaborates with Assistant Director of Quality and Quality Improvement S ...