Remote Healthcare Grievance and Appeals Specialist

Job ID: Available for Members

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: Wed, Aug 05, 2020

Job Category: Healthcare, Insurance

Remote Level: 100% Remote

Weekly Hours: Full Time

Employment Status: Permanent

Employer Type: Employer

Career Level: Experienced

Job Summary

A health insurance company needs applicants for an opening for a Remote Grievance and Appeals Specialist.

Must be able to:

  • Manage client medical denials
  • Conduct comprehensive analytic reviews of clinical documentation
  • Perform advanced administrative and/or customer support duties

Applicants must meet the following qualifications:

  • 2+ years working with customers in a fast-paced, deadline-oriented environment
  • Possesses a High School Diploma or GED
  • Prior experience interpreting Member Benefits and Medical Claims
  • Experience with the ability to prioritize and manage inventory and work flow
  • Customer focused, analytical and decision making skills