Appeals and Grievance Specialist Job in Boston, Massachusetts Us

Job Description The Appeals and Grievance Specialist is responsible for managing the overall coordination, investigation, documentation and the resolution process of medical and pharmacy member appeals and/or member generated complaints/grievances, and ensuring compliance with contractual obligations, regulatory requirements and accreditation standards.Key Functions/Responsibilities:Appeals Responsibilities:Coordinates management of member appeals across multiple departments within the Plan and with representatives from external vendors.Ensures compliance with MassHealth directives in a manner Read more […]

January 2, 2011 • Tags: , • Posted in: General • Comments Off on Appeals and Grievance Specialist Job in Boston, Massachusetts Us