- Molina Healthcare (Bothell, WA)
- …**Essential Job Duties** * Facilitates comprehensive research and resolution of appeals , disputes, grievances , and/or complaints from Molina members, providers, ... internal and/or regulatory timelines are met. * Researches claims appeals and grievances using support systems to...subrogation and eligibility criteria. * Experience with Medicaid and Medicare claims denials and appeals processing, and… more
- Molina Healthcare (Doral, FL)
- …with research. * Determines appropriate language for letters and prepares responses to member appeals and grievances . * Elevates appropriate appeals to the ... problem-solving in an efficient and timely manner. * Creates and/or maintains appeals and grievances related statistics and reporting. * Collaborates with… more
- J&J Family of Companies (Cherry Hill, NJ)
- …(ie, eligibility and benefit verification, pre-authorization, billing, coding, claims, and appeals / grievances ); practice management; Medicare and Medicaid ... **Job Description:** We are searching for the best talent for Senior Area Business Specialist to be in South New Jersey. Territory includes: Cherry Hill, Toms River,… more
- Molina Healthcare (Milwaukee, WI)
- …to healthcare premium. * Assist in resolution for escalated premium issues with Appeals and Grievances team members. * Guide and collaborates with enrollment ... timely and accurate processing of payment received.* Marketplace, Commercial, or Medicare healthcare experience with premium billing and reconciliation. * Must have… more
- State of Colorado (Pueblo, CO)
- …after hours. + Addresses patient complaints/complaints of family and resolves patient grievances at the unit level. + Aware of patient allergies, sensitivities of ... Patient Rights. Demonstrates understanding of the role of the Patient Right Specialist and utilizes this person as a resource when necessary. Clinical Skills:… more
- Cedars-Sinai (Beverly Hills, CA)
- …the payor + Investigates, processes and assists with the resolution of provider grievances and appeals in accordance with contractual requirements and corporate ... + Coordinates discharge planning and alternative treatment plans with PCP/hospitalist/ specialist as appropriate. + Coordinates the patient's care with other… more
Related Job Searches:
Appeals,
Appeals Grievances,
Appeals Specialist,
Grievances,
Medicare,
Medicare Appeals,
Specialist,
Specialist Appeals Grievances