Oregon Licensed Appeals Specialist

Job Summary

A company is looking for an Appeals and Grievance Specialist for a short-term position.

Key Responsibilities

• Provide program support for the Grievance System, including handling complaints, appeals, and regulatory reporting
• Ensure proper administration of health plan grievance system functions, including documentation and tracking
• Prepare and monitor grievance system reporting and analysis activities

Required Qualifications

• Bachelor's degree in health administration, public health, or a health-related field
• Minimum of three years' experience in medical claims processing, complaints and appeals, or the health insurance industry
• Knowledge of Oregon Health Plan (OHP) benefit package and OHA rules and regulations
• Ability to work independently and collaboratively within a diverse team
• Excellent organizational skills and ability to manage multiple tasks simultaneously