Regulatory and Appeals Advisor

Job Summary

A company is looking for a Regulatory and Appeals Advisor.

Key Responsibilities

• Manage and respond to member complaints, grievances, and appeals
• Conduct research and document findings for case determinations
• Collaborate with cross-functional teams to ensure regulatory compliance and improve processes

Required Qualifications

• High school diploma or equivalent
• 3+ years of experience in the health insurance industry, with at least 1 year in appeals and grievances
• Experience with Government Programs products is preferred