Grievance Appeals Specialist

Job Summary

A company is looking for a Grievance & Appeals Specialist II (NSA).

Key Responsibilities

• Review and validate appeals submitted by Medicaid and Medicare providers
• Prepare appeals for clinical review and track outcomes from Appeals Committee meetings
• Process various types of appeals and resolve them within regulatory timeframes

Required Qualifications

• High school diploma or equivalent is required
• Associates Degree or equivalent years of relevant work experience preferred
• Minimum of two (2) years of healthcare customer service, claims, compliance, or related experience is required