- CenterWell (Tallahassee, FL)
- …the Denials Management data analytics, denial and appeal process. The Director, Home Health Grievances & Appeals assists members, via phone or face to face, ... and clinical policy development/implementation required + Expert knowledge of all Medicare regulations and appeals processes + Excellent analytical skills… more
- Molina Healthcare (St. Petersburg, FL)
- …Provider/Member Inquiry Research and Resolution; and Provider/Member Appeals and Grievances . * Coordinates with Corporate and Business Development teams to ... reimbursement tolerance parameters (across multiple specialties/geographies). Obtains input from Corporate , Legal and other stakeholders regarding new reimbursement models… more