9:30am-6pm PST; Holiday rotation. Position Purpose: The Grievance and Appeals Assistant is responsible for ensuring.... Maintain comprehensive knowledge of all products. Receives appeal and grievance requests via the 800 appeals phone line...
determinations for grievance and appeals appropriate for their specialty. Ensures consistent use of medical policies when making...
. Provides Referrals to Quality Management (QM), Disease Management (DM) and Appeals and Grievance department (AGD). Conducts...
administration, grievance resolution and investigations. Provides interpretation and guidance to hourly supervisors and managers... grievance avoidance LR practices such as training leaders on how to manage a union workforce, understanding the CBA and positive...
. Provides Referrals to Quality Management (QM), Disease Management (DM) and Appeals and Grievance department (AGD). Conducts...
to meet regulatory timeframes. Documents and logs appeal/grievance information on relevant tracking systems and mainframe...