- Point32Health (GA)
- …responsible for the accurate coordination, efficient administration and resolution of member appeals and member grievances submitted by Point32Health members for ... + Must be able to organize, plan and implement the functions of Member Appeals and Grievances , maintain timelines and turnaround times to meet multiple… more
- Molina Healthcare (GA)
- …Member/Provider issues in areas involving member/provider impact and engagement including: Appeals and Grievances , Problem Research and Resolution, and the ... a wide variety of inquiries and assistance involving claims, authorizations, appeals , contracting, credentialing and other areas including the most complex issues.… more
- Highmark Health (Atlanta, GA)
- …paid clams review. + Participate as pharmacy representative in onsite member appeals and grievances sessions. + Serve as a resource for technical staff. ... + Other duties as assigned or requested. **QUALIFICATIONS:** **Minimum** + High school diploma or GED + Experience in pharmacy prescription claims processing/submission/payment. **Preferred** + Associate degree + Pharmacy technician certification certificate +… more
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