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

Mar 18, 2025 - 15:41

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