Grievances Appeals Representative

Job Summary

A company is looking for a Grievances & Appeals Representative 2.

Key Responsibilities:

• Manage client denials and concerns through comprehensive analytic review of clinical documentation
• Assign cases to associates and communicate effectively with leadership
• Work Monday to Friday with rotating weekend shifts, handling large volumes of inventory

Required Qualifications:

• Minimum 1 year of customer service and data entry experience in a production-driven environment
• Passion for improving consumer experiences
• Associate's or Bachelor's Degree preferred
• Experience with MedHok, medical claims processing, and Medicare
• Ability to manage a large volume of inventory