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Complaint and Appeals Specialist
A company is looking for a Cdr, Complaint & Appeals. Key Responsibilities Review and process appeals filed by participating providers Assist with adherence to regulatory requirements and conduct internal audits Draft and send appeal decision letters Required Qualifications 1 year of experience with HMO and Traditional claim platforms, patient management, and compliance analysis Experience in provider relations, customer service, or audit High School diploma or equivalent
A company is looking for a Cdr, Complaint & Appeals.
Key Responsibilities
Review and process appeals filed by participating providers
Assist with adherence to regulatory requirements and conduct internal audits
Draft and send appeal decision letters
Required Qualifications
1 year of experience with HMO and Traditional claim platforms, patient management, and compliance analysis
Experience in provider relations, customer service, or audit
High School diploma or equivalent