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, entering denials and appeals into the information system
• Research claims issues and collaborate with provider and member services to resolve complaints
• Prepare documentation and responses for appeals and grievances while ensuring compliance with guidelines

Required Qualifications

• At least 1 year of experience in claims or customer/provider service in a health care setting
• Customer service experience
• Organizational and time management skills
• Proficiency in Microsoft Office suite/applicable software programs
• Completion of a health care related vocational program is preferred