Job Description Provides support for provider denial coding dispute activities. Investigates and resolves disputes related to provider appeals, and ensures that claims adhere to correct billing standards and regulations. Essential Job Duties Reviews coding-related provider claims denials by
Job Description Provides senior level support for coding activities. Responsible for monitoring adherence to Molinas compliance program, minimizing risks related to coding and billing practices, and protecting the business from liability related to fraudulent/abusive practices. Performs chart reviews,
Job Title Provides lead level support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. Contributes to overarching