Remote Appeals and Grievances Analyst in Lansing

Location: Michigan

Compensation: To Be Discussed

Staff Reviewed: Tue, Sep 29, 2020

This job expires in 10 days

Job Category: Healthcare, Insurance

Remote Level: Partially Remote

Employer Type: Employer

Education Level: Bachelors, Masters

Job Summary

An enrollment technology platform is seeking a Remote Appeals and Grievances Analyst in Lansing.

Individual must be able to fulfill the following responsibilities:

  • Follow Grievances and Appeals processes and systems
  • Investigate and thoroughly document findings on all grievances and appeals
  • Prepare Appeal case recommendations for initial review process

Required Skills:

  • Minimal travel
  • Five years experience in a grievance and appeals environment
  • Experience in medical benefits and health care industry regulations and processes
  • Experience working in or with Medicare Advantage plans, or Independent Review Entities
  • Experience with CMS regulations regarding Medicare Advantage, and Medicare Advantage plans appeals
  • Bachelor's in Business Administration, Economics, Health Care, Information Systems, Statistics or related