Job Summary

A business services provider for healthcare firms is searching for a person to fill their position for a Remote Complaint and Appeal Analyst in Nashville.

Core Responsibilities Include:

• Coordinate with internal departments to effectively identify appeals & complaints in a timely & appropriate manner
• Coordinate components of appeals, complaints including final communication to member & provider for final resolution & closure

Must meet the following requirements for consideration:

• Experience in Medicaid/CHIP/CHIP Perinate products and benefits
• Experience in provider relations, customer service and audit experience are preferred
• Experience in managed care organization compliance and regulatory requirements
• Experience in research and analysis of claim processing is preferred
• Experience in medical claims systems and medical management