Medicaid Appeals & Grievances Specialist

Molina Healthcare is seeking a claims reviewer for the Medicaid and Marketplace line of business in the United States. The role involves researching and resolving member and provider appeals and complaints in alignment with CMS standards and Molina guidelines. Applicants should have 2+ years in a managed care claims/appeals environment, experience with Medicaid/Medicare denials, and strong organizational and communication skills to ensure timely responses across all cases.