• Appeals & Grievances…

    Molina Healthcare (Covington, KY)
    …**Essential Job Duties** * Facilitates comprehensive research and resolution of appeals , disputes, grievances , and/or complaints from Molina members, providers, ... to ensure that internal and/or regulatory timelines are met. * Researches claims appeals and grievances using support systems to determine appropriate appeals… more
    Molina Healthcare (12/14/25)
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  • Grievance Specialist -Health Plan

    BayCare Health System (Park Lake, KY)
    …is completed and filed appropriately, and communicating effectively with all parties involved. + Provide reports on the status of grievances and provide ... updates to management. + Identify trends or recurring issues in member grievances and appeals and recommend process improvements to prevent future occurrences. +… more
    BayCare Health System (12/23/25)
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