CPC Certified Appeals Analyst

Job Summary

A company is looking for an Appeals Analyst.

Key Responsibilities

• Analyze, research, and resolve confidential appeals and grievances in accordance with regulatory guidelines
• Interpret and explain health plan benefits and medical terminology to members and providers
• Document investigations and monitor compliance with service timeliness and regulatory standards

Required Qualifications

• Bachelor's degree or advanced degree where required
• 3 years of related experience, or 5 years in lieu of a degree
• CPC certification required