Remote Grievance and Appeals Specialist

Location: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Puerto Rico, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, Wisconsin

Compensation: Hourly

Staff Reviewed: Tue, Oct 06, 2020

This job expires in 5 days

Job Category: Insurance

Job Summary

A health insurance company is in need of a Remote Grievance and Appeals Specialist.

Individual must be able to fulfill the following responsibilities:

  • Manage client medical denials by conducting a comprehensive analytic review
  • Perform advanced administrative and/or customer support duties
  • Prioritize requests and interpret and adapt procedures

Position Requirements Include:

  • 2+ years working with customers in a fast-paced, deadline-oriented environment
  • Minimum 1 year of experience interpreting Member Benefits and Medical Claims
  • High School Diploma or GED
  • Experience with the ability to prioritize and manage inventory and work flow
  • Able to work overtime including weekends, based on business needs
  • Distraction-free home office with high speed Internet