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WellSense Health Plan
Overview
The Appeals and Grievance Specialist manages the resolution process of medical and pharmacy member appeals and complaints, ensuring compliance with various regulations. This role involves executing member appeals, coordinating grievances, and communicating with members and providers.
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Compensation
$48,500 - $70,500 / YEAR
Posted
21 days ago
SlateRx
The Clinical Coordinator will support clinical functions related to coverage determinations and appeals, ensuring efficiency, accuracy, and timeliness in reviewing these requests according to SlateRx policies. Key duties involve creating case files, researching claim rejections, contacting prescribers for information, configuring outcomes in the adjudication system, and handling related communications.
$23 - $26 / HOUR
3 months ago
Avamere
The Social Services Coordinator ensures residents' emotional, mental, and psychosocial needs are met by developing comprehensive care plans and coordinating safe discharge planning with the interdisciplinary team. This role involves acting as a resident advocate, communicating with families and providers, and arranging necessary ancillary services and post-discharge supports.
Salary not listed
The Social Services Coordinator ensures the medically related emotional, mental, and psychosocial needs of residents are met while working under the Social Services Director. This role involves coordinating safe discharge planning and acting as a liaison between residents, families, providers, and payors to continue care.
$30 - $35 / HOUR
