Appeals Grievance Team Lead

Job Summary

A company is looking for an Appeals & Grievance Case Resolution Team Lead.

Key Responsibilities

• Lead and oversee a team of Appeals & Grievance Specialists and Administrators
• Ensure compliance with regulatory requirements and monitor team performance
• Conduct quality assurance checks and collaborate with internal teams for case resolution

Required Qualifications

• High School/GED required; Associate's Degree in Health Administration, Business, or related field preferred
• 1 or more years of leadership or mentoring experience
• 5 or more years of experience in healthcare operations, managed care, or grievance/appeals coordination
• Knowledge of medical terminology and regulatory processes preferred
• Experience with CMS, Medicaid, or state-regulated appeals processes preferred