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
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