- Molina Healthcare (Atlanta, GA)
- …+ 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 (Atlanta, GA)
- …research and resolution of the complex or escalated and high dollar appeals , grievances , and/or complaints from Molina members, providers and related ... outside agencies. + Research claims appeals and grievances using support systems to determine appeal and grievance outcomes. + Requests and reviews medical… more
- Molina Healthcare (Atlanta, GA)
- …of Program Integrity Specialist , Molina Medicare, direct supervision of the Manger Appeals and Grievances , Molina Medicare and for providing direction to the ... to Medicare. * Responsible for the direct supervision of Program Integrity Specialist , Molina Medicare and for matrix super vision of Director Auditing, Molina… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …card distribution, accurate provider directories, performance on VBC contracts, benefit adjudication, appeals , and grievances . + Collaborate with the TPA to ... to enhance member experience with a focus on engagement. HEALTH AND WELLNESS SPECIALIST : + Develop and implement health and wellness programs to boost member… more