Appeals Representative

Job Summary

Working remotely in a full-time capacity, the Appeals Representative will research and resolve written complaints from consumers and providers, ensuring proper categorization and documentation of cases while communicating decisions within required timeframes.

Key responsibilities:

• Research and resolve written complaints submitted by consumers and providers
• Ensure accurate categorization of complaints and obtain necessary documentation for case reviews
• Render decisions for non-clinical complaints and communicate findings to relevant parties

Required qualifications:

• High School Diploma / GED or equivalent work experience
• 1+ years of experience analyzing and solving customer problems
• 1+ years of experience working in a remote environment
• Proficiency with computer applications, including Microsoft Word and Outlook
• Ability to work between 7:00 am - 5:00 pm MST, Monday - Friday