Claims Support Specialist 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
Job Title Claims Recovery Specialist Job Description Job Summary Provides support for claims recovery activities including researching claim payment and billing guidelines, audit results, and federal regulations to determine overpayment accuracy and provider compliance. Collaborates with health
Audit Support For Enterprise Risk Adjustment Provides audit support for Molina enterprise risk adjustment activities. Responsible for developing, recommending and implementing controls and cost-effective approaches to minimize the organizations risks effects. Identifies and analyzes potential sources