Molina Healthcare
Specialist, Appeals & Grievances
United States
Sponsorship not specifiedDetected 1 day ago
Research
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odds of building a lasting career here
31Risky
Cap-exempt (no lottery)0
Sponsors this role58
Entry-level history0
PERM / green-card track0
Lottery odds40
Fits your clock70
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About the role
- JOB DESCRIPTION Job Summary Provides support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution to members or authorized representatives in accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). Essential Job Duties • Facilitates
- comprehensive research and resolution of appeals, disputes, grievances, and/or complaints from Molina members, providers, and related outside agencies to ensure that internal and/or regulatory timelines are met. • Researches claims appeals and grievances using support systems to determine appropriate appeals and grievance outcomes. • Requests and reviews
Responsibilities
- Researches claims appeals and grievances using support systems to determine appropriate appeals and grievance outcomes.
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This listing is sourced directly from Molina Healthcare's careers page and normalized into a canonical job model.