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Vanderbilt Health

Nashville, Tennessee

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MemorialCare Health System

Fountain Valley, California

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ChristianaCare Health System

Newark, Delaware

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Banner Health

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MemorialCare Health System

Fountain Valley, California

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Nashville, Tennessee

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Banner Health

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Banner Health

Phoenix, Arizona

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Altamonte Springs, Florida

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Banner Health

Phoenix, Arizona

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Nashville, Tennessee

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Mesa, Arizona

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AdventHealth

Edgewater, Florida

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AdventHealth

Altamonte Springs, Florida

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Daytona Beach, Florida

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Remote, Washington

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Dallas, Texas

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Memorial Sloan Kettering Cancer Center

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Nashville, Tennessee

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Memorial Sloan Kettering Cancer Center

Uniondale, New York

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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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