Health Insurance Appeals Analyst

Job Summary

Joining a leading health insurance organization, the full-time Health Insurance Appeals Analyst will analyze and resolve complex member and provider concerns remotely, ensuring compliance with regulatory requirements while managing a high-volume caseload.

Key responsibilities

• Analyze, research, and resolve appeals, grievances, and coverage determinations
• Review health plan benefits, policies, and medical coding information
• Communicate with providers and members to gather information and ensure timely resolutions

Required qualifications

• Bachelor's degree with 3 years of related experience, or 5 years of related experience in lieu of a degree
• Experience in the Medicare and health insurance industry
• Strong time management and workload prioritization skills
• Ability to research and resolve complex issues independently
• Preferred experience in appeals, grievances, or claims and medical coding