• Specialist , Appeals

    Molina Healthcare (Atlanta, GA)
    …+ 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 (04/09/25)
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  • Pharmacy Medicare Specialist

    Intermountain Health (Atlanta, GA)
    …the formulary transition process. + Assists Medicare and Medicaid members with grievances , coverage determination (including exceptions), and appeals process. + ... **Job Description:** The Pharmacy Government Specialist II is responsible for the day-to-day operations of Government programs, providing superior customer service… more
    Intermountain Health (04/29/25)
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  • National Contracting Director

    Molina Healthcare (Atlanta, GA)
    …for claims payment); Provider/ Member Inquiry Research and Resolution; and Provider/ Member Appeals and Grievances . * Coordinates with Corporate ... hospitals, and other health care providers. * Contributes as a key member of the department's leadership team and participates in committees addressing the… more
    Molina Healthcare (03/04/25)
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