Massachusetts Licensed Appeals Analyst
A company is looking for an Appeals and Grievance Analyst.
Key Responsibilities
Act as a member advocate by clearly communicating the appeal and grievance process
Manage assigned member appeals and grievances, ensuring compliance with regulatory requirements
Review and interpret product and benefit designs according to State and Federal regulations
Qualifications
Associates Degree or equivalent experience in health care, conflict resolution, or related field
3-5 years of health care or insurance experience
Health care benefit and regulatory knowledge preferred
Knowledge of insurance products, policies, and procedures preferred
Ability to understand and comply with State and Federal regulations
A company is looking for an Appeals and Grievance Analyst.
Key Responsibilities
Act as a member advocate by clearly communicating the appeal and grievance process
Manage assigned member appeals and grievances, ensuring compliance with regulatory requirements
Review and interpret product and benefit designs according to State and Federal regulations
Qualifications
Associates Degree or equivalent experience in health care, conflict resolution, or related field
3-5 years of health care or insurance experience
Health care benefit and regulatory knowledge preferred
Knowledge of insurance products, policies, and procedures preferred
Ability to understand and comply with State and Federal regulations