Dispute and Appeals Analyst

A company is looking for a Dispute and Appeals Analyst to support the resolution of member grievances and appeals. Key Responsibilities Analyze and research service denials or modifications and gather relevant information for appeals Collaborate with various stakeholders to ensure timely and accurate resolution of grievances and appeals Document final determinations and prepare cases for presentation to resolution teams Required Qualifications 2+ years of experience with appeals, grievances, and member complaints Experience presenting cases to Administrative Law Judges at state fair hearings Proficiency in Microsoft Office and familiarity with Windows PCs Ability to compose clear written correspondence and translate complex terms for members Flexibility to work outside of standard hours as needed

Jun 10, 2025 - 15:30

A company is looking for a Dispute and Appeals Analyst to support the resolution of member grievances and appeals. Key Responsibilities Analyze and research service denials or modifications and gather relevant information for appeals Collaborate with various stakeholders to ensure timely and accurate resolution of grievances and appeals Document final determinations and prepare cases for presentation to resolution teams Required Qualifications 2+ years of experience with appeals, grievances, and member complaints Experience presenting cases to Administrative Law Judges at state fair hearings Proficiency in Microsoft Office and familiarity with Windows PCs Ability to compose clear written correspondence and translate complex terms for members Flexibility to work outside of standard hours as needed