- Molina Healthcare (Detroit, MI)
- Molina Healthcare is hiring for a Medicare Appeals & Grievances Specialist . This position is remote and will be working Pacific Standard hours. Highly ... **Essential Job Duties** * Facilitates comprehensive research and resolution of appeals , disputes, grievances , and/or complaints from Molina members, providers,… more
- Molina Healthcare (Detroit, MI)
- …+ 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 (Detroit, MI)
- …and prepare responses to appeals and grievances . + Elevates appropriate appeals to the Appeals Specialist . + Generates and mails denial letters. ... systems and other available resources. + Assures timeliness and appropriateness of appeals according to state and federal and Molina Healthcare guidelines. +… more
- Molina Healthcare (Detroit, MI)
- …* At least 2 years of managed care experience in a call center, appeals , and/or claims environment, or equivalent combination of relevant education and experience. * ... and eligibility criteria. * Experience with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines for appeals and… more
- Molina Healthcare (Detroit, MI)
- Molina Healthcare is hiring for an Appeals & Grievance Specialist . This role is 100% remote and will work in the Pacific Time Zone. This role provides support ... **Essential Job Duties** + Facilitates comprehensive research and resolution of appeals , disputes, grievances , and/or complaints from Molina members, providers,… more