VIVA HEALTH has been recognized by Centers for Medicare & Medicaid Services (CMS) as a high ... Ability to use critical thinking skills to develop solutions to non-clinical issues using fact ...
VIVA HEALTH has been recognized by Centers for Medicare & Medicaid Services (CMS) as a high ... Ability to use critical thinking skills to develop solutions to non-clinical issues using fact ...
Clinical Pharmacy Technicians
Tuscaloosa, AL · Remote
$70 - $80/hr
Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... This opportunity is ideal for professionals experienced in authoring and reviewing complex safety ...
Clinical Pharmacy Technicians
Tuscaloosa, AL · Remote
$70 - $80/hr
Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... This opportunity is ideal for professionals experienced in authoring and reviewing complex safety ...
Clinical Pharmacy Technicians
Mobile, AL · Remote
$70 - $80/hr
Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... This opportunity is ideal for professionals experienced in authoring and reviewing complex safety ...
Clinical Pharmacy Technicians
Mobile, AL · Remote
$70 - $80/hr
Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... This opportunity is ideal for professionals experienced in authoring and reviewing complex safety ...
Clinical Pharmacy Technicians
Huntsville, AL · Remote
$70 - $80/hr
Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... This opportunity is ideal for professionals experienced in authoring and reviewing complex safety ...
Clinical Pharmacy Technicians
Huntsville, AL · Remote
$70 - $80/hr
Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... This opportunity is ideal for professionals experienced in authoring and reviewing complex safety ...
Clinical Pharmacy Technicians
Montgomery, AL · Remote
$70 - $80/hr
Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... This opportunity is ideal for professionals experienced in authoring and reviewing complex safety ...
Clinical Pharmacy Technicians
Montgomery, AL · Remote
$70 - $80/hr
Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... This opportunity is ideal for professionals experienced in authoring and reviewing complex safety ...
Clinical Pharmacy Technicians
Birmingham, AL · Remote
$70 - $80/hr
Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... This opportunity is ideal for professionals experienced in authoring and reviewing complex safety ...
Clinical Pharmacy Technicians
Birmingham, AL · Remote
$70 - $80/hr
Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... This opportunity is ideal for professionals experienced in authoring and reviewing complex safety ...
... or pricing/value roles in B2B technology * Strong financial modeling (ROI/TCO), executive ... Why work for Octave? All in. Always forward. That's the way we do things around here. We put trust ...
... or pricing/value roles in B2B technology * Strong financial modeling (ROI/TCO), executive ... Why work for Octave? All in. Always forward. That's the way we do things around here. We put trust ...
RN Case Manager - Telephonic - Alabama ONLY
Mobile, AL · Remote
$60K - $107K/yr
... development for other roles you may be interested in. Required Qualifications: * Current ... Proven ability to work with diverse care teams in a variety of settings including non-clinical ...
RN Case Manager - Telephonic - Alabama ONLY
Mobile, AL · Remote
$60K - $107K/yr
... development for other roles you may be interested in. Required Qualifications: * Current ... Proven ability to work with diverse care teams in a variety of settings including non-clinical ...
Remote Skidder Operator
Cullman, AL · On-site +1
$20 - $30/hr
For more information, visit www.kodama.ai. Position: We are seeking an experienced Skidder Operator ... Contribute to cross-team company initiatives during non-operating time such as customer outreach ...
Remote Skidder Operator
Cullman, AL · On-site +1
$20 - $30/hr
For more information, visit www.kodama.ai. Position: We are seeking an experienced Skidder Operator ... Contribute to cross-team company initiatives during non-operating time such as customer outreach ...
Serve as CRA for assigned complex clinical studies, providing expert oversight of site selection, initiation, monitoring, and closeout activities (onsite, virtual, remote). * Actively participate in ...
Serve as CRA for assigned complex clinical studies, providing expert oversight of site selection, initiation, monitoring, and closeout activities (onsite, virtual, remote). * Actively participate in ...
Licensed Mental Health Professional (LPC/LMFT/LCSW) - Huntsville, AL (REMOTE)
Huntsville, AL · On-site +1
$60K - $85K/yr
Remote Full-Time and Part-time Positions Available FLSA Status: Exempt Location: Huntsville, AL ... It is common for clinicians to diversify their work today. Therefore, OMH's "work from home" and ...
Licensed Mental Health Professional (LPC/LMFT/LCSW) - Huntsville, AL (REMOTE)
Huntsville, AL · On-site +1
$60K - $85K/yr
Remote Full-Time and Part-time Positions Available FLSA Status: Exempt Location: Huntsville, AL ... It is common for clinicians to diversify their work today. Therefore, OMH's "work from home" and ...
Licensed Mental Health Professional (LPC/LMFT/LCSW) - Hoover, AL (REMOTE)
Hoover, AL · On-site +1
$60K - $85K/yr
Remote Full-Time and Part-time Positions Available FLSA Status: Exempt Location: Hoover, AL Salary ... It is common for clinicians to diversify their work today. Therefore, OMH's "work from home" and ...
Licensed Mental Health Professional (LPC/LMFT/LCSW) - Hoover, AL (REMOTE)
Hoover, AL · On-site +1
$60K - $85K/yr
Remote Full-Time and Part-time Positions Available FLSA Status: Exempt Location: Hoover, AL Salary ... It is common for clinicians to diversify their work today. Therefore, OMH's "work from home" and ...
Licensed Mental Health Professional (LPC/LMFT/LCSW) - Tuscaloosa, AL (REMOTE)
Tuscaloosa, AL · On-site +1
$60K - $85K/yr
Remote Full-Time and Part-time Positions Available FLSA Status: Exempt Location: Tuscaloosa, AL ... It is common for clinicians to diversify their work today. Therefore, OMH's "work from home" and ...
Licensed Mental Health Professional (LPC/LMFT/LCSW) - Tuscaloosa, AL (REMOTE)
Tuscaloosa, AL · On-site +1
$60K - $85K/yr
Remote Full-Time and Part-time Positions Available FLSA Status: Exempt Location: Tuscaloosa, AL ... It is common for clinicians to diversify their work today. Therefore, OMH's "work from home" and ...
Licensed Mental Health Professional (LPC/LMFT/LCSW) - Prattville, AL (REMOTE)
Prattville, AL · On-site +1
$60K - $85K/yr
Remote Full-Time and Part-time Positions Available FLSA Status: Exempt Location: Prattville, AL ... It is common for clinicians to diversify their work today. Therefore, OMH's "work from home" and ...
Licensed Mental Health Professional (LPC/LMFT/LCSW) - Prattville, AL (REMOTE)
Prattville, AL · On-site +1
$60K - $85K/yr
Remote Full-Time and Part-time Positions Available FLSA Status: Exempt Location: Prattville, AL ... It is common for clinicians to diversify their work today. Therefore, OMH's "work from home" and ...
Licensed Mental Health Professional (LPC/LMFT/LCSW) - Dothan, AL (REMOTE)
Dothan, AL · On-site +1
$60K - $85K/yr
Remote Full-Time and Part-time Positions Available FLSA Status: Exempt Location: Dothan, AL Salary ... It is common for clinicians to diversify their work today. Therefore, OMH's "work from home" and ...
Licensed Mental Health Professional (LPC/LMFT/LCSW) - Dothan, AL (REMOTE)
Dothan, AL · On-site +1
$60K - $85K/yr
Remote Full-Time and Part-time Positions Available FLSA Status: Exempt Location: Dothan, AL Salary ... It is common for clinicians to diversify their work today. Therefore, OMH's "work from home" and ...
Licensed Mental Health Professional (LPC/LMFT/LCSW) - Enterprise, AL (REMOTE)
Enterprise, AL · On-site +1
$60K - $85K/yr
Remote Full-Time and Part-time Positions Available FLSA Status: Exempt Location: Enterprise, AL ... It is common for clinicians to diversify their work today. Therefore, OMH's "work from home" and ...
Licensed Mental Health Professional (LPC/LMFT/LCSW) - Enterprise, AL (REMOTE)
Enterprise, AL · On-site +1
$60K - $85K/yr
Remote Full-Time and Part-time Positions Available FLSA Status: Exempt Location: Enterprise, AL ... It is common for clinicians to diversify their work today. Therefore, OMH's "work from home" and ...
Licensed Mental Health Professional (LPC/LMFT/LCSW) - Huntsville, AL (REMOTE)
Huntsville, AL · On-site +1
$60K - $85K/yr
Remote Full-Time and Part-time Positions Available FLSA Status: Exempt Location: Huntsville, AL ... It is common for clinicians to diversify their work today. Therefore, OMH's "work from home" and ...
Licensed Mental Health Professional (LPC/LMFT/LCSW) - Huntsville, AL (REMOTE)
Huntsville, AL · On-site +1
$60K - $85K/yr
Remote Full-Time and Part-time Positions Available FLSA Status: Exempt Location: Huntsville, AL ... It is common for clinicians to diversify their work today. Therefore, OMH's "work from home" and ...
Licensed Mental Health Professional (LPC/LMFT/LCSW) - Alabaster, AL (REMOTE)
Alabaster, AL · On-site +1
$60K - $85K/yr
Remote Full-Time and Part-time Positions Available FLSA Status: Exempt Location: Alabaster, AL ... It is common for clinicians to diversify their work today. Therefore, OMH's "work from home" and ...
Licensed Mental Health Professional (LPC/LMFT/LCSW) - Alabaster, AL (REMOTE)
Alabaster, AL · On-site +1
$60K - $85K/yr
Remote Full-Time and Part-time Positions Available FLSA Status: Exempt Location: Alabaster, AL ... It is common for clinicians to diversify their work today. Therefore, OMH's "work from home" and ...
Licensed Mental Health Professional (LPC/LMFT/LCSW) - Opelika, AL (REMOTE)
Opelika, AL · On-site +1
$60K - $85K/yr
Remote Full-Time and Part-time Positions Available FLSA Status: Exempt Location: Opelika, AL Salary ... It is common for clinicians to diversify their work today. Therefore, OMH's "work from home" and ...
Licensed Mental Health Professional (LPC/LMFT/LCSW) - Opelika, AL (REMOTE)
Opelika, AL · On-site +1
$60K - $85K/yr
Remote Full-Time and Part-time Positions Available FLSA Status: Exempt Location: Opelika, AL Salary ... It is common for clinicians to diversify their work today. Therefore, OMH's "work from home" and ...
Licensed Mental Health Professional (LPC/LMFT/LCSW) - Decatur, AL (REMOTE)
Decatur, AL · On-site +1
$60K - $85K/yr
Remote Full-Time and Part-time Positions Available FLSA Status: Exempt Location: Decatur, AL Salary ... It is common for clinicians to diversify their work today. Therefore, OMH's "work from home" and ...
Licensed Mental Health Professional (LPC/LMFT/LCSW) - Decatur, AL (REMOTE)
Decatur, AL · On-site +1
$60K - $85K/yr
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Remote Non Clinical Roles For Optometrists information
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Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Posted 16 days ago
Viva Health rating
8.1
Based on 5 frontline employees who took The Breakroom Quiz
156th of 311 rated insurance
Job description
Member Appeals & Grievances Specialist
Location: Birmingham, Alabama
Work Schedule: This position will primarily work from the VIVA HEALTH headquarters in downtown Birmingham. After training has been completed, there would be an opportunity to work 1 day per week from home.
Job Summary
The Member Appeals & Grievances Specialist will analyze and resolve all Medicare appeals and grievances received from members, non-contracted providers and government entities. This role will coordinate a timely resolution according to state and federal guidelines and VIVA HEALTH policies and procedures. This position will participate in an on-call rotation to process appeals and grievances on weekends and holidays.
Why VIVA HEALTH?
VIVA HEALTH, part of the renowned University of Alabama at Birmingham (UAB) Health System, is a health maintenance organization providing quality, accessible health care. Our employees are a part of the communities they serve and proudly partner with members on their healthcare journeys.
VIVA HEALTH has been recognized by Centers for Medicare & Medicaid Services (CMS) as a high-performing health plan and has been repeatedly ranked as one of the nation's Best Places to Work by Modern Healthcare.
Benefits
- Comprehensive Health, Vision, and Dental Coverage
- 401(k) Savings Plan with company match and immediate vesting
- Paid Time Off (PTO)
- 9 Paid Holidays annually plus a Floating Holiday to use as you choose
- Tuition Assistance
- Flexible Spending Accounts
- Healthcare Reimbursement Account
- Paid Parental Leave
- Community Service Time Off
- Life Insurance and Disability Coverage
- Employee Wellness Program
- Training and Development Programs to develop new skills and reach career goals
- Employee Assistance Program
See more about the benefits of working at Viva Health - https://www.vivahealth.com/careers/benefits
Key Responsibilities
- Process member and non-contracted provider Medicare Part C and Part D grievances and appeals according to federal and state regulations and internal, organizational policies and procedures.
- Collaborate with internal and external subject matter experts to obtain benefit and/or clinical opinions/interpretations.
- Identify training, process improvement, and other ways to maximize plan performance and customer satisfaction.
- Act as subject matter expert regarding grievances and appeals.
- Prepare for and participate in all required audits.
- Participate in on-call rotation on weekends and holidays.
REQUIRED QUALIFICATIONS:
- High School diploma or GED
- 1 – 3 years’ experience in managed care, health care customer service, or appeals and grievances
- Excellent written and verbal communication skills, interpersonal skills, organization skills, and the ability to handle multiple tasks
- Ability to carefully follow processes in sequential order
- Ability to meet established productivity, schedule adherence, and quality standards
- Knowledge of computer platforms and applications of Microsoft Office
- Ability to use critical thinking skills to develop solutions to non-clinical issues using fact-based decision making
- Ability to work occasional planned and unplanned overtime to meet deadlines with minimal supervision
PREFERRED QUALIFICATIONS:
- Associates’ Degree
- Experience working with the elderly population
- 1 – 3 years’ experience processing Medicare appeals and grievances
- Knowledge of Medicare regulations
- Experience with administrative and/or coordinator positions with exposure to PHI
About Viva Health
Sourced by ZipRecruiter
Industry
Insurance services
Company size
201 - 500 Employees
Headquarters location
Birmingham, AL, US
Year founded
1995