- Molina Healthcare (Cincinnati, OH)
- …* Manages team responsible for the submission/resolution of member and provider appeals and grievances ; ensures resolutions are compliant with applicable ... call tracking system of correspondence and outcomes for provider and member appeals / grievances ; oversees/monitors appeals to ensure all internal and… more
- Elevance Health (Cincinnati, OH)
- …analyzing and processing non-complex and some complex pre service and post service grievances and appeals requests in the Enterprise Grievance & Appeals ... + The analyst may serve as a liaison between grievances & appeals and /or medical management,...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Molina Healthcare (Cincinnati, OH)
- …Design scalable workflows and controls across intake, adjudication, adjustments, appeals / grievances , and payment integrity. + Technology Enablement: Oversee ... understanding of claims lifecycle, EDI transactions, payment integrity, provider data, appeals / grievances , and audit/compliance (CMS, HIPAA, NCQA, state regs). +… more
- Elevance Health (Mason, OH)
- …relevant parties of all prior authorization determinations. + Provides resolution to grievances and appeals issues. + Managing inbound and outbound ... in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance Health location at least… more
- Elevance Health (Mason, OH)
- …relevant parties of all prior authorization determinations. + Provides resolution to grievances and appeals issues. + Responds to inquiries from physicians, ... in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance Health location at least… more