Massachusetts Licensed Appeals Analyst

Job Summary

A company is looking for an Appeals & Grievance Analyst.

Key Responsibilities

• Manage and coordinate member appeals and grievances in compliance with regulatory requirements
• Act as a member advocate by clearly communicating the appeal and grievance process
• Collect and review necessary documentation for thorough investigation and resolution of cases

Required Qualifications, Training, and Education

• Associates Degree or equivalent experience in health care, conflict resolution, or a related field
• 3-5 years of health care or insurance experience
• Preferred knowledge of health care benefits and regulatory requirements
• Familiarity with insurance products, policies, and procedures is preferred
• Ability to work independently and as part of a team