- Molina Healthcare (Yonkers, NY)
- …8am-5pm PST hours** Must be able to rotate weekends and holidays** Must have Medicare Appeals and IRE experience** **Job Summary** Responsible for reviewing and ... + Responsible for the comprehensive research and resolution of the appeals , dispute, grievances , and/or complaints from Molina members, providers… more
- Molina Healthcare (Yonkers, NY)
- …and evaluate appeal and grievance request to identify and classify member grievances , hand-off to appropriate department for appeals ; regulatory complaints as ... of benefits, subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory… more
- Molina Healthcare (Yonkers, NY)
- …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...subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and… more