- Staffing Solutions Organization (Albany, NY)
- …clarification of policies and procedures which may include marketing, enrollment, grievances and appeals , provider/plan education, and quality monitoring ... is a reflection of our clients and the people they serve. **Healthcare Data Specialist 1 in Albany, NY** **Division of Health Plan Contracting & Oversight (DHPCO)… more
- Molina Healthcare (Albany, NY)
- …**Essential Job Duties** * Facilitates comprehensive research and resolution of appeals , disputes, grievances , and/or complaints from Molina members, providers, ... that internal and/or regulatory timelines are met. * Researches claims appeals and grievances using support systems to determine appropriate appeals and… more
- Molina Healthcare (Albany, NY)
- …+ Responsible for the comprehensive research and resolution of the appeals , dispute, grievances , and/or complaints from Molina members, providers ... that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance outcomes. +… more
- Molina Healthcare (Albany, NY)
- …DESCRIPTION** **Job Summary** Responsible for reviewing and resolving Medicare member appeals and Medicare claims in communicating resolution to members and provider ... + Responsible for the comprehensive research and resolution of the appeals from Molina members, providers and related outside agencies to ensure… more
- Intermountain Health (Albany, NY)
- **Job Description:** The RCO Appeals Hearing Specialist is responsible for investigating, coordinating and managing legal insurance cases and represents ... Intermountain Health in OIG hearings and 1st level grievances with insurance companies and CMS. This position communicates regularly with various levels of internal… more
