Appeals Grievance Specialist

A company is looking for an Appeals-Grievance Specialist I. Key Responsibilities Manage and resolve member and provider appeals and grievances Investigate, document, and facilitate resolutions while ensuring satisfaction Ensure compliance with regulatory standards throughout the appeals process Required Qualifications, Training, and Education Bachelor's degree in healthcare, business, or a related field, or equivalent relevant experience Experience in computer applications, including Microsoft Office Suite Experience in appeals and grievances is strongly preferred Familiarity with healthcare laws and regulations related to appeals and grievances Proficiency in case management software and adaptability to new technology

Mar 7, 2025 - 11:40

A company is looking for an Appeals-Grievance Specialist I. Key Responsibilities Manage and resolve member and provider appeals and grievances Investigate, document, and facilitate resolutions while ensuring satisfaction Ensure compliance with regulatory standards throughout the appeals process Required Qualifications, Training, and Education Bachelor's degree in healthcare, business, or a related field, or equivalent relevant experience Experience in computer applications, including Microsoft Office Suite Experience in appeals and grievances is strongly preferred Familiarity with healthcare laws and regulations related to appeals and grievances Proficiency in case management software and adaptability to new technology