Appeals and Grievances Clinical Specialist
France Cars SAS AAA(5 days ago)
About this role
The Clinical Specialist in Appeals & Grievances at Healthfirst manages clinical case development and resolution, ensuring compliance with regulatory standards. They handle member and provider complaints, investigate cases, and prepare cases for review or appeal. The role requires independent case management with a focus on clinical and regulatory accuracy.
Required Skills
- CaseManagement
- Regulations
- HealthInsurance
- Investigation
- ClinicalKnowledge
- Documentation
- AppealsProcess
- UtilizationReview
- HealthPolicy
- Communication
Qualifications
- RN
- LPN
About France Cars SAS AAA
bloomberg.comBloomberg is a global leader in financial information and technology, providing data, news, and analytics to financial professionals around the world. The company offers an array of products and services, including the Bloomberg Terminal, which delivers real-time data and insights for trading, investment, and risk management. With a commitment to innovation, Bloomberg combines cutting-edge technology with extensive market expertise to empower financial professionals in making informed decisions.
View more jobs at France Cars SAS AAA →Apply instantly with AI
Let ApplyBlast auto-apply to jobs like this for you. Save hours on applications and land your dream job faster.
More jobs at France Cars SAS AAA
Similar Jobs
Coordinator, Appeals & Grievances
Evolent Specialty Services, Inc(8 days ago)
Appeals & Grievances Coordinator
Brigham and Women(1 month ago)
Appeals & Grievances Coordinator
Brigham and Women(1 month ago)
Job Posting Title Grievances & Appeals Representative
Humana(1 month ago)
Manager, Home Health Grievances & Appeals
Humana(1 month ago)
Grievances & Appeals Specialist
Modivcare(2 months ago)