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Baylor Scott & White Health

Austin, Texas

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Duke University Health System

Durham, North Carolina

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Baylor Scott & White Health

Georgetown, Texas

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Baylor Scott & White Health

Georgetown, Texas

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Kindred Healthcare

Riviera Beach, Florida

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Banner Health

Mesa, Arizona

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Marshfield Clinic Health System

Marshfield, WI, Wisconsin

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Richmond, Virginia

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Veterans Affairs, Veterans Health Administration

Amarillo, Texas

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AdventHealth

Wesley Chapel, Florida

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Baylor Scott & White Health

Waco, Texas

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St Louis, Missouri

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Rush University Medical Center

Chicago, Illinois

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DMC Harper University/Hutzel Women's Hospital

Detroit, Michigan

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Geisinger

Jersey Shore, Pennsylvania

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WMC Health

Valhalla, New York

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Biolife Plasma Services

Pittsburgh, Pennsylvania

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Baylor Scott & White Health

Georgetown, Texas

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AdventHealth

Wesley Chapel, Florida

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AdventHealth

Orlando, Florida

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Appeals and Grievance Specialist
JOB SUMMARYThe Appeals and Grievance Specialist performs reviews, within operational aspects, of the member and provider complaints, appeals and grievance cases for products for all lines of business. Responsibilities include, but are not limited to: timely classification and resolution of cases; review, research and coordination of complaints, grievances, appeals and reconsiderations consistent with statutory and federal regulatory guidelines.ESSENTIAL FUNCTIONS OF THE ROLEMaintains data entry requirements for all complaints, appeals and grievances.Builds case files for each complaint, appeal and grievance, and ensures compliance with organizational and regulatory guid


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