Grievance/Appeals Representative I - Woburn

This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity. · ...

This role combines structured office engagement with virtual work flexibility. · The Grievance/Appeals Representative I reviews customer complaints and processes claims according to policies. · Conducts investigations and researches policy provisions. · Gathers information from c ...

+Job summary · This role requires associates to be in-office - 2 days per week. · The Grievance/Appeals Representative I is responsible for reviewing, analyzing and processing member complaints in accordance with policies and claims events to determine the extent of the company's ...

The Grievance/Appeals Representative I will review analyze and process claims in accordance with policies and claims events to determine the extent of the company's liability and entitlement. · This role requires associates to be in-office 1-2 days per week fostering collaboratio ...

The Grievance/Appeals Representative I is responsible for reviewing and processing member complaints in accordance with policies and claims events to determine the extent of the company's liability. · The role requires associates to be in-office 1 - 2 days per week, fostering col ...

+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). · ...

+ 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 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 ...

The Appeals and Grievances Coordinator will coordinate process and document all aspects of member appeals grievances as well as provider appeals across all our product offerings Commercial Medicaid Medicare. · Bachelor's Degree Related Field of Study preferred · ...

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. · ...

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. · ...

Who We Are · Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to prov ...

Under the general direction of the Member Appeals and Grievance Supervisor the Member Appeals and Grievance Analyst is responsible per State and Federal regulations for the professional and compliant management and coordination of assigned member appeals and grievance (complaints ...

Under the general direction of the Member Appeals and Grievance Supervisor the Member Appeals and Grievance Analyst is responsible per State and Federal regulations for the professional and compliant management and coordination of assigned member appeals and grievance (complaints ...

Job summaryUnder the general direction of the Member Appeals and Grievance Supervisor appeals analyst responsible per State and Federal regulations for professional management coordination of assigned member appeals grievances received by Point32Health. · ...

The Appeals Analyst role at Point32Health involves professional management and coordination of member appeals and grievances under State and Federal regulations. This position requires superior customer service skills, benefit interpretation knowledge, and ability to work indepen ...

The Member Appeals and Grievance Analyst is responsible for the professional and compliant management · and coordination of assigned member appeals · and grievances received by Point32Health.This individual works collaboratively with the member · and/or the member's authorized r ...

Under the general direction of the Member Appeals and Grievance Supervisor the Member Appeals and Grievance Analyst is responsible per State and Federal regulations for the professional and compliant management and coordination of assigned member appeals and grievance (complaints ...

We are currently looking for an Appeals and Grievance Analyst to join our team at Point32Health. As an Appeals and Grievance Analyst you will be responsible for managing member appeals and grievances in accordance with State and Federal regulations. · You will work collaborativel ...

Under the general direction of the Member Appeals · and Grievance Supervisor the Member Appeals · and Grievance Analyst is responsible per State · and Federal regulations for the professional · and compliant management coordination of assigned member appeals · grievances recei ...