Appeals-Grievances Coordinator - Pearland, TX

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partne ...

This position leads quality reviews for the KelseyCare Advantage Operations Department, including Appeals & Grievances · ...

This position leads quality reviews for the KelseyCare Advantage Operations Department, · Responsibilities include analyzing eligibility data and reviewing CMS transaction reports, · loading weekly files and identifying errors. · ...

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partne ...

Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. · ...

The position leads quality reviews for the KelseyCare Advantage Operations Department. · Analyzing eligibility data and reviewing CMS transaction reports. · Loading weekly files and optimizing workflows. · ...

This position leads quality reviews for the KelseyCare Advantage Operations Department. It addresses system issues and collaborates with IT and management to resolve them. · The role supports process improvements and ensures effective use of health plan information and CMS guidel ...

The Data Intake Specialist is responsible for accurately entering, reviewing, and validating data in departmental processing systems. · ...

We are seeking a Data Intake Specialist to accurately enter, review, and validate data in departmental processing systems at Kelsey-Seybold Clinic. · The ideal candidate will have 1+ years of healthcare industry experience or 3+ years of customer service experience. The role requ ...

Explore opportunities with Kelsey-Seybold Clinic... · ...

The Data Intake Specialist is responsible for accurately entering, reviewing, and validating data in departmental processing systems, maintaining a 99% accuracy standard. · This role processes mail, including faxes, emails, · written correspondence and calls from Member Services. ...

We are seeking a Utilization Review Specialist (LVN) to join our team at Kelsey-Seybold Clinic. As a key member of our health care organization, you will be responsible for conducting medical reviews, benefit verification, and applying criteria to determine medical necessity for ...

We have an exciting opportunity for a Utilization Review Specialist (LVN) to join our team at Kelsey-Seybold Clinic in Houston. · The successful candidate will be responsible for conducting medical reviews, benefit verification, and applying criteria to determine medical necessit ...

We are seeking a Utilization Review Specialist to conduct medical reviews, benefit verification, and apply criteria to determine medical necessity for health care services requiring authorization prior to rendering services to members. · The selected candidate will serve as a lia ...

We are seeking a Utilization Review Specialist (LVN) to join our team at Kelsey-Seybold Clinic. As a key member of our utilization review team, you will be responsible for conducting medical reviews and applying criteria to determine medical necessity for healthcare services requ ...

The Utilization Review Specialist (LVN) serves as a liaison in reviewing requests for medical and surgical procedures, services and admissions. · Conduct medical reviews, benefit verification, and apply criteria to determine medical necessity for health care services requiring au ...

The Data Intake Specialist is responsible for accurately entering, reviewing and validating data in departmental processing systems. · This role processes mail including faxes emails written correspondence and calls from Member Services while requesting and adding necessary docum ...

Explore opportunities with Kelsey-Seybold Clinic to help drive higher quality and patient satisfaction while working on third-party account receivables. · ...

+Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. · + · +This role processes mail and provides critical support to multiple teams by ensuring accurate data entry and seamless communication. · The Specialist identifies workflow improvements ...

About The Opportunity · Location: Pearland, TX · Join a dynamic and innovative team in the marketing sector at a high-paced company dedicated to excellence in driving brand engagement and customer satisfaction. Our marketing department thrives on creativity and collaboration, emb ...