- Actalent (Dallas, TX)
- Job Title: Specialist , Appeals & GrievancesJob Summary: Responsible for reviewing and resolving member and provider complaints and communicating resolutions. Key ... Responsibilities: + Conduct comprehensive research and resolve appeals , disputes, grievances, and complaints. + Use internal systems to determine outcomes of claims … more
- Cognizant (Austin, TX)
- …applicant that lives in the United States. **Summary:** We are seeking a dedicated Provider Appeals & Grievance Specialist with 1 to 2 years of experience ... **Provider Appeals & Grievances Specialist ** (remote) This...and state Medicaid policies. **Qualifications/Skills Needed:** 1-2 years of Appeals and Grievance 1 yr. medical claims… more
- Molina Healthcare (Fort Worth, TX)
- …+ Responsible for the comprehensive research and resolution of the appeals , dispute, grievances, and/or complaints from Molina members, providers and related ... to ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance … more