- Cognizant (Austin, TX)
- **Provider 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 Provider Appeals & Grievance Specialist with 1 to...with CMS Billing and Coding-Medical Insurance Knowledge of Member/Provider Appeals and Grievances , processes, resolutions, compliance TAT… more
- Molina Healthcare (Austin, TX)
- …+ Responsible for the comprehensive research and resolution of the appeals , dispute, grievances , and/or complaints from Molina members, providers ... that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance outcomes. +… more
- Actalent (Dallas, TX)
- Job Title: Specialist , Appeals & GrievancesJob Summary: Responsible for reviewing and resolving member and provider complaints and communicating resolutions. Key ... Responsibilities: + Conduct comprehensive research and resolve appeals , disputes, grievances , and complaints. + Use internal systems to determine outcomes of… more
- Cognizant (Austin, TX)
- …or clinic operations . Experience in utilization management to include Clinical Appeals and Grievances , precertification, initial and concurrent reviews . ... . Maintain working knowledge of applicable health insurers' internal claims, appeals , and retro-authorization as well as timely filing deadlines and processes.… more
- Keurig Dr Pepper (Frisco, TX)
- …Thursday or option to be 100% onsite. The **Associate HR Operations Leave Specialist ** is part of the myHR team, a world-class, value-added, and customer-focused ... assistance on maneuvering complex leave claims ie: Leave denials and appeals process, guidance on return to work, reasonable accommodations, concurrent leaves… more
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