Job Summary

A company is looking for a Supervisor of Appeals and Grievances.

Key Responsibilities:

• Supervising staff handling member and provider inquiries, appeals, disputes, and grievances to ensure compliance
• Monitoring inventory management, compliance, and audit readiness
• Assessing and auditing business processes to enhance efficiency in resolving member and provider issues

Required Qualifications:

• Bachelor's degree or equivalent experience
• 3-5 years of experience in claims review, provider inquiries, appeals, disputes, and grievances resolution
• 3-5 years of Managed Care experience
• Experience in reviewing all types of medical claims
• Previous experience leading projects or in a lead role