grievance

Accenture in the Philippines is seeking a Health Clinical Svcs Specialist to manage grievance and appeal workflows, prepare complete records, and craft detailed case narratives for regional review. The role requires a BSN/GN/BSN-equivalent, an active US RN license, and a minimum of 3 months clinical experience providing direct patient care in inpatient or...

The Appeals & Grievance Coordinator is responsible for the day-to-day functions of the tracking and trending of all grievances, appeals, and complaints received within the Member Services Department. Acts as the primary investigator and contact person for member and provider grievances and appeals. GENERAL DUTIES/RESPONSIBILITIES: Acknowledges the receipt...

DMPE Solutions in the Philippines seeks an Appeals & Grievance Coordinator to manage day-to-day tracking of grievances and appeals within Member Services. You will act as the primary investigator and contact for member and provider grievances and appeals.The role requires data entry, office administration and strong customer service experience, with...

The Appeals & Grievance Coordinator is responsible for the day-to-day functions of the tracking and trending of all grievances, appeals, and complaints received within the Member Services Department. Acts as the primary investigator and contact person for member and provider grievances and appeals. GENERAL DUTIES/RESPONSIBILITIES: -Acknowledges the receipt...

DME Service Solutions is seeking an Appeals & Grievance Coordinator to manage the day-to-day tracking and trending of grievances, appeals, and complaints within Member Services. You will investigate, document, and communicate resolutions per CMS guidelines and plan policy.The role emphasizes gathering information, conducting unbiased investigations, and...

USRN - A&G in Taguig invites a dedicated nursing professional to independently process complex grievances and appeals, ensuring accuracy and SLA adherence. You will review medical necessity across inpatient, outpatient, and ancillary services, and prepare documentation for regulatory standards, collaborating with the Medical Director as needed. The role...

USRN - A&G in Taguig invites a dedicated nursing professional to independently process complex grievances and appeals, ensuring accuracy and SLA adherence. You will review medical necessity across inpatient, outpatient, and ancillary services, and prepare documentation for regulatory standards, collaborating with the Medical Director as needed. The role...

USRN - A&G in Taguig invites a dedicated nursing professional to independently process complex grievances and appeals, ensuring accuracy and SLA adherence. You will review medical necessity across inpatient, outpatient, and ancillary services, and prepare documentation for regulatory standards, collaborating with the Medical Director as needed. The role...

MangoJob- Recruitment Platform in the Philippines is seeking an Employee Relations Officer to manage employee concerns, workplace cases, and fair policy application. This on-site role in Mandaluyong requires 1-3 years of HR experience and a Bachelor's degree.The successful candidate will document grievances, support investigations, prepare disciplinary...

USRN - A&G in Taguig invites a dedicated nursing professional to independently process complex grievances and appeals, ensuring accuracy and SLA adherence. You will review medical necessity across inpatient, outpatient, and ancillary services, and prepare documentation for regulatory standards, collaborating with the Medical Director as needed.The role...

USRN - A&G in Taguig invites a dedicated nursing professional to independently process complex grievances and appeals, ensuring accuracy and SLA adherence. You will review medical necessity across inpatient, outpatient, and ancillary services, and prepare documentation for regulatory standards, collaborating with the Medical Director as needed.The role...

USRN - A&G in Taguig invites a dedicated nursing professional to independently process complex grievances and appeals, ensuring accuracy and SLA adherence. You will review medical necessity across inpatient, outpatient, and ancillary services, and prepare documentation for regulatory standards, collaborating with the Medical Director as needed.The role...

USRN - A&G in Taguig invites a dedicated nursing professional to independently process complex grievances and appeals, ensuring accuracy and SLA adherence. You will review medical necessity across inpatient, outpatient, and ancillary services, and prepare documentation for regulatory standards, collaborating with the Medical Director as needed.The role...

USRN - A&G in Taguig invites a dedicated nursing professional to independently process complex grievances and appeals, ensuring accuracy and SLA adherence. You will review medical necessity across inpatient, outpatient, and ancillary services, and prepare documentation for regulatory standards, collaborating with the Medical Director as needed.The role...

USRN - A&G in Taguig invites a dedicated nursing professional to independently process complex grievances and appeals, ensuring accuracy and SLA adherence. You will review medical necessity across inpatient, outpatient, and ancillary services, and prepare documentation for regulatory standards, collaborating with the Medical Director as needed.The role...

USRN - A&G in Taguig invites a dedicated nursing professional to independently process complex grievances and appeals, ensuring accuracy and SLA adherence. You will review medical necessity across inpatient, outpatient, and ancillary services, and prepare documentation for regulatory standards, collaborating with the Medical Director as needed.The role...

Rebisco Group is seeking an Employee Relations Associate to foster positive employee relationships and ensure compliance with company policies and labor regulations. The role involves handling employee concerns, supporting investigations, and maintaining confidential records.The ideal candidate will have a bachelor’s degree in a relevant field, 1–3 years...

Accenture PLC in Taguig, Philippines is seeking a Health Clinical Svcs Specialist to support grievance and appeals processes. The role is a return-to-office setup, requiring an RN with current US licensure and a minimum of 3 months clinical experience. Responsibilities include preparing appeal records, creating narrative case summaries, and presenting...

USRN - A&G in Taguig invites a dedicated nursing professional to independently process complex grievances and appeals, ensuring accuracy and SLA adherence. You will review medical necessity across inpatient, outpatient, and ancillary services, and prepare documentation for regulatory standards, collaborating with the Medical Director as needed. The role...

HealthEdge in Taguig, Philippines, is seeking a qualified USRN-licensed professional to independently process complex grievances and appeals. The role requires clinical knowledge, regulatory familiarity, and strong communication to ensure quality output aligned with SLAs. Responsibilities include reviews for medical necessity, documentation, and serving as a...