Hawaii Licensed Appeals Representative

Job Summary

A company is looking for a Senior Appeals Representative to manage appeals and grievances in a remote setting.

Key Responsibilities

• Research and resolve written complaints from consumers and providers
• Ensure proper categorization of complaints and gather necessary documentation
• Render decisions on non-clinical complaints and communicate outcomes within required timeframes

Required Qualifications

• High School Diploma / GED or equivalent work experience
• Must be 18 years of age or older
• 2+ years of experience in analyzing appeals and grievances or in a healthcare setting
• Proficiency with computer and Windows PC applications
• Ability to work full time with flexibility for shift schedules and occasional overtime