- CenterWell (Atlanta, GA)
- …compliance. Manages the Denials Management data analytics, denial and appeal process. The Director , Home Health Grievances & Appeals assists members, via phone ... a part of our caring community and help us put health first** The Director Denials Management provides leadership for the audit, appeal and review process to… more
- Molina Healthcare (Atlanta, GA)
- …corrective actions. * Conducts retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. * Attends or chairs ... JOB DESCRIPTION Job Summary Provides medical oversight and expertise in appropriateness and ...leadership and quality improvement teams. * Facilitates conformance to Medicare , Medicaid, NCQA and other regulatory requirements. * Reviews… more