Specialist, Appeals & Grievances - Remote EST Hours

من الإعلان الأصلي

M-F 8:30am - 5pm EST must be flexiable to work on weekends due to buisness needs. 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…