Entry-Level Appeals Specialist

Job Summary

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

Key Responsibilities

• Review and resolve member and provider complaints, ensuring compliance with CMS standards
• Enter denials and appeals requests into the system, preparing necessary documentation for review
• Collaborate with provider and member services to address balance bill issues and other complaints

Required Qualifications

• At least 1 year of experience in claims or customer/provider service in a healthcare setting
• Organizational and time management skills for managing multiple tasks
• Proficiency in Microsoft Office suite or applicable software programs
• Customer service experience
• Experience in a managed care organization or medical office is preferred