Appeals and Grievances Specialist at Molina Healthcare - New York City, New York Appeals and Grievances Specialist - Molina Healthcare

Appeals and Grievances Specialist

Molina Healthcare

Location: New York City, New York, USA

Category: Healthcare

Salary: 21 - 38 USD / hourly

Full-time


Job Description

Responsible for reviewing and resolving member and provider complaints in compliance with healthcare standards and regulations.

Responsibilities

Research and resolve appeals, disputes, grievances, and complaints from members and providers. Contact members/providers for communication. Prepare appeal summaries and correspondence concisely and accurately.

Qualifications

High School Diploma or equivalency required. Min. 2 years operational managed care experience in appeals or claims environment. Familiarity with Medicaid and Medicare claims processing.

Perks & Benefits

Competitive benefits and compensation package offered. Equal Opportunity Employer (EOE) M/F/D/V.