- Molina Healthcare (San Antonio, TX)
- …+ Responsible for the comprehensive research and resolution of the appeals , dispute, grievances , and/or complaints from Molina members, providers ... internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to...of benefits, subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals … 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