- Molina Healthcare (Atlanta, GA)
- …+ 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
- Sharecare (Atlanta, GA)
- …+ Research and resolution to eligibility, claims issues, ID card issues, grievances / appeals , utilization management (UM) statusincluding but not limited to ... with providers,** **payers** **or 3rd parties for:** + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status… more
- Molina Healthcare (Atlanta, GA)
- …for claims payment); Provider/Member Inquiry Research and Resolution; and Provider/Member Appeals and Grievances . * Coordinates with Corporate and Business ... Provides training and guidance as needed to the Contract Managers and Contract Specialist (s). * Helps develop and utilize standardized contract templates and Pay for… more