Appeals & Grievances Clinical Specialist
Healthfirst
US$69,484 - $69,484 est.Full-timePosted 5 days ago
Duties and Responsibilities: Ensures that appeals and grievances are properly classified (e.g. denial of service, denial of payment, or a grievance about a provider) Processes appeals and grievances in accordance with internal company policy Enters data into appropriate medical management services Collaborates with other departments to thoroughly investigate appeal and grievances. Prepares for and participates in regulatory site visits. Additional duties as assigned. Minimum Qualification…
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