Molina Healthcare

Specialist, Appeals & Grievances

Molina Healthcare

Louisville, KY, USA
Full-TimeDepends on ExperienceSenior LevelMasters
Job Description

Molina Healthcare is looking for a Specialist, Appeals & Grievances to join our team. The ideal candidate will be a highly motivated, detail-oriented individual with strong interpersonal and communication skills. This position will be a critical part of our Member Services team, responsible for managing and resolving appeals and grievances. As a Specialist, Appeals & Grievances, you will be expected to provide a high level of customer service, ensure accuracy of data and compliance, and execute proactive strategies to mitigate complaints and appeals.To be successful in this role, you must have a Bachelor’s degree in a related field, a minimum of two years’ experience in a customer service, appeals and/or health care environment, and strong computer and analytical skills. You must also have a strong understanding of health care regulations and be able to work collaboratively in a fast-paced environment. If you have an upbeat attitude, an eye for detail and a passion for providing exceptional customer service, we want to hear from you!

Where is this job?
This job is located at Louisville, KY, USA
Job Qualifications
  • Excellent Written And Verbal Communication Skills

  • Ability To Multitask And Prioritize

  • Proficient In Microsoft Office

  • Ability To Work Independently And In A Team Environment

  • Knowledge And Understanding Of Healthcare Industry

  • Ability To Comprehend And Interpret Medical Records

  • Ability To Meet Performance Goals

  • Ability To Review And Analyze Medical Records

Required Skills
  • Documenting

  • Meeting deadlines

  • Interpreting

  • Coordinating

  • Problem-Solving

  • Reviewing

  • Managing

  • communicating

  • Negotiating

  • Analyzing

  • Adapting

  • Facilitating

  • Investigating

  • Mediating

  • Following-Up

Soft Skills
  • Communication

  • Leadership

  • Negotiation

  • Problem Solving

  • Time management

  • Interpersonal Skills

  • creativity

  • Critical thinking

  • Teamwork

  • Adaptability

Compensation

According to JobzMall, the average salary range for a Specialist, Appeals & Grievances in Louisville, KY, USA is between $35,000 and $64,000 per year. This range includes base salary, bonuses, and other forms of compensation.

Additional Information
Molina Healthcare is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate based upon race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.
Required LanguagesEnglish
Job PostedMay 8th, 2023
Apply BeforeJune 21st, 2025
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About Molina Healthcare

Molina Healthcare is a managed care company headquartered in Long Beach, California, United States. The company provides health insurance to individuals through government programs such as Medicaid and Medicare.

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