- Molina Healthcare (Houston, TX)
- Molina Healthcare is hiring for an Appeals & Grievance Specialist . This role is remote and will be working an Eastern Time Zone schedule. The Appeals & ... Specialist will be responsible for reviewing and resolving member disputes/complaints and communicating resolution to members or authorized representatives) in… more
- Molina Healthcare (Dallas, TX)
- …evaluate appeal and grievance request to identify and classify member grievances , hand-off to appropriate department for appeals ; regulatory complaints as ... organizing and directing the activities of the Grievance and Appeals Unit that is responsible for reviewing and resolving... Unit that is responsible for reviewing and resolving member grievances , regulatory complaints, Medicaid Fair Hearings… more
- Molina Healthcare (San Antonio, TX)
- …research and resolution of the complex or escalated and high dollar appeals , grievances , and/or complaints from Molina members, providers and related ... Unit that is responsible for reviewing and resolving member and provider complaints and communicating resolution to members...outside agencies. + Research claims appeals and grievances using support systems to… more
- Baylor Scott & White Health (Temple, TX)
- …and/or level **Job Summary** **Hybrid position - limited time working onsite** The Appeals and Grievance Specialist reviews member and provider complaints, ... of cases. They also review, research, and coordinate complaints, grievances , appeals , and reconsiderations following statutory and...able to work well autonomously and as a team member . + Knowledge of basic medical terminology a plus.… more