- Molina Healthcare (Buffalo, NY)
- …and evaluate appeal and grievance request to identify and classify member grievances , hand-off to appropriate department for appeals ; regulatory complaints as ... for leading, organizing and directing the activities of the Grievance and Appeals Unit that is responsible for reviewing and resolving member grievances… more
- Independent Health (Buffalo, NY)
- …responsible for the collection and review of medical records specific to quality complaints/ grievances and appeals as indicated in support of a high performing ... plan and physician network. The Clinical Reviewer will investigate quality complaints/ grievances and appeals , document research of initial coverage… more