- Molina Healthcare (Boise, ID)
- …+ Responsible for the comprehensive research and resolution of the appeals , dispute, grievances , and/or complaints from Molina members, providers ... to ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance… more
- Molina Healthcare (Boise, ID)
- …and prepare responses to appeals and grievances . + Elevates appropriate appeals to the Appeals Specialist . + Generates and mails denial letters. ... **JOB DESCRIPTION** **Job Summary** Responsible for reviewing and resolving member & provider complaints and communicating resolution to members (or authorized)… more
- Molina Healthcare (ID)
- … Member issues in areas involving member impact and engagement including: Appeals and Grievances , Member Problem Research and Resolution, and the ... development/maintenance of Member Materials. **Knowledge/Skills/Abilities** * Serves as an advocate for...subcontractors and enrollees. * Monitors all formal and informal grievances with Grievance personnel to identify trends or problem… more