Appeals and Grievance Analyst

Job Summary

A company is looking for an Appeals and Grievance Analyst.

Key Responsibilities

• Manage and coordinate member appeals and grievances in compliance with regulatory requirements
• Act as a member advocate, clearly communicating the appeal and grievance processes
• Prepare documentation for review and participate in committee discussions as needed

Required Qualifications, Training, and Education

• Associate's Degree or equivalent experience in healthcare or related field; Bachelor's Degree preferred
• 2-4 years of experience in customer service or member services in healthcare or insurance; 2 years of Appeals and Grievance experience preferred
• Knowledge of healthcare benefits and regulatory requirements preferred
• Ability to independently plan and prioritize work efficiently
• Experience with Windows applications and related computer systems