technical and administrative support to Grievance and Appeals dept. to ensure that departmental goals are met. Perform.... * Resolution of Disputes and Closure of Grievance and Appeals For disputes: receive and/or monitor reports and portals...
Summary of Job Respond to written/verbal grievances, complaints, appeals and disputes submitted by members... and providers in accordance with NCQA, CMS, State and other regulations. Process appeals and grievances to facilitate the accurate...
Summary of Job Respond to written/verbal grievances, complaints, appeals and disputes submitted by members... and providers in accordance with NCQA, CMS, State and other regulations. Process appeals and grievances to facilitate the accurate...
criteria. Enters data and assists with compiling reports and analysis on the grievance and appeals process. Participates..., including a minimum of two years in a grievance and appeals or related area such as medical or utilization management...
of correspondence handled by Grievance and Appeals (Required) Proficiency in MS Office (Word, Excel, PowerPoint, Outlook, Teams...Summary of Job Responsible for processing expedited appeals: those that are complex in nature, require multiple hand...