Massachusetts Licensed Member Appeals Specialist

Job Summary

Detail-oriented and collaborative, the remote Massachusetts Licensed Member Appeals Specialist will manage member appeal cases from intake through resolution, ensuring compliance with regulatory requirements and maintaining an active caseload.

Key responsibilities

• Manage member appeal cases, ensuring all steps are completed within established timelines
• Review appeal requests, verify eligibility, and prepare appeal-related correspondence
• Communicate with members and internal stakeholders to gather information and support case progression

Required qualifications

• Experience managing member appeals in a healthcare or regulated benefits environment
• Ability to independently manage a high-volume caseload while meeting strict deadlines
• Strong attention to detail with the ability to interpret policies and procedures accurately
• Excellent written communication skills, including professional email etiquette
• Demonstrated success working in a remote, team-oriented environment