- Molina Healthcare (Yonkers, NY)
- …apply state level requirements to meet contract and regulatory expectations. * Establishes Appeals & Grievances department policies and procedures in line with ... and interprets trends and prepares reports that identify root causes for Appeals , Grievances , and Provider Disputes. Recommends and implements process… more
- Molina Healthcare (Rochester, NY)
- …and directing the activities of the Medicare Contracted Provider Post-Pay Claim Appeals and Disputes in accordance with the standards and requirements established by ... the activities of the Medicare Contracted Provider Post-Pay Claim Appeals and Disputes that is responsible for reviewing and... and grievance processing/resolution, including 2 years in a manager role. * Experience reviewing all types of medical… more
- Molina Healthcare (Yonkers, NY)
- …and Marketplace request authorization. Strongly prefer candidates with a background in appeals and grievances . Excellent computer multi-tasking skills and good ... office with internet connectivity of high speed required **Job Summary** Clinical Appeals is responsible for making appropriate and correct clinical decisions for … more
- CUNY (Brooklyn, NY)
- …Rules); tracking student conduct reports; coordinating the student conduct process, grievances , and appeals . + Oversee the Faculty Student Disciplinary ... Manager of Student Advocacy and Accountability (HEA) **POSITION...intervention student support service process, the resolution of student grievances , appeals , and complaints, and the utilization… more
- University of Rochester (Albany, NY)
- …of claims. Collaborate with appropriate departments to generate a detailed rational for appeals and grievances to the insurance companies. + 10% Keeps management ... Receivable Management. **ESSENTIAL FUNCTIONS** With general direction of the Manager /Supervisor/Lead: + 40% Follows department policies and procedures and maintains… more