Accident and Health Insurance Specialist

Job Summary

A company is looking for a Grievance & Appeals Resolutions Specialist III.

Key Responsibilities

• Ensure full resolution of HICS and CTM cases within regulatory timeframes
• Research and resolve discrepancies associated with membership eligibility
• Analyze operations and suggest process improvements for HICS and CTM case resolution

Required Qualifications

• Associate Degree in business, finance, or related field preferred
• Minimum of three (3) years of customer service or claims experience required
• Prior experience in managed care or healthcare industry preferred
• Experience in enrollment, billing, finance, or data analysis preferred
• Current, unrestricted State Insurance License in Accident and Health required