- Cognizant (Tallahassee, FL)
- ** Member Appeals & Grievances Specialist ** (remote) This is a remote position open to any qualified applicant that lives in the United States. ... **Summary:** We are seeking a dedicated Member Appeals & Grievance Specialist ...directly with CMS Billing and Coding-Medical Insurance Knowledge of Member /Provider Appeals and Grievances , processes,… more
- Molina Healthcare (Tampa, FL)
- Molina Healthcare is hiring for a Medicare Appeals & Grievances Specialist . This position is remote and will be working Pacific Standard hours. Highly ... **Essential Job Duties** * Facilitates comprehensive research and resolution of appeals , disputes, grievances , and/or complaints from Molina members, providers,… more
- Molina Healthcare (Orlando, FL)
- Molina Healthcare is hiring for an Appeals & Grievance Specialist . This role is 100% remote and will work in the Pacific Time Zone. This role provides support ... **Essential Job Duties** + Facilitates comprehensive research and resolution of appeals , disputes, grievances , and/or complaints from Molina members, providers,… more
- Molina Healthcare (Tampa, FL)
- …+ 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 (Orlando, FL)
- …with research. * Determines appropriate language for letters and prepares responses to member appeals and grievances . * Elevates appropriate appeals ... problem-solving in an efficient and timely manner. * Creates and/or maintains appeals and grievances related statistics and reporting. * Collaborates with… more
- Molina Healthcare (Tampa, FL)
- …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 (Tampa, FL)
- **JOB DESCRIPTION** **Job Summary** Responsible for reviewing and resolving Medicare member appeals and Medicare claims in communicating resolution to members ... + Responsible for the comprehensive research and resolution of the appeals from Molina members, providers and related outside agencies to ensure… more
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