
Specialist, Appeals & Grievances
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!
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
Documenting
Meeting deadlines
Interpreting
Coordinating
Problem-Solving
Reviewing
Managing
communicating
Negotiating
Analyzing
Adapting
Facilitating
Investigating
Mediating
Following-Up
Communication
Leadership
Negotiation
Problem Solving
Time management
Interpersonal Skills
creativity
Critical thinking
Teamwork
Adaptability
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.
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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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