Appeals and Grievances Specialist

Job Summary

A company is looking for an Associate Specialist, Appeals & Grievances.

Key Responsibilities

• Review and resolve member and provider complaints related to claims activities
• Research claims issues and prepare documentation for appeals
• Generate denial letters and maintain related statistics and reporting

Required Qualifications

• At least 1 year of experience in claims or customer/provider service in a health care setting
• Organizational and time management skills
• Proficiency in Microsoft Office suite or applicable software programs
• Customer service experience