Job Responsibilities: Gather, analyze and report verbal and written member and provider complaints, grievances and appeals Prepare response letters for member and provider complaints, grievances and appeals Maintain files on individual appeals and grievances May coordinate the Grievance and Appeals Committee…
Perform duties to act as a liaison between providers, the health planand Corporate. Perform training, orientation and coaching for performanceimprovement within the network and assist with claim resolution.Job Responsibilities: Serve as primary contact for providers and act as a liaison…
Job Responsibilities: Resolve customers’ service or billing complaints by performing activities such as exchanging merchandise, refunding money, and adjusting bills. Contact customers to respond to inquiries or to notify them of claim investigation results and any planned adjustments. Refer unresolved…