Wisconsin Appeals Specialist

Job Summary

A company is looking for an Appeals and Grievances Specialist.

Key Responsibilities

• Review and investigate appeals and grievances, compiling necessary documentation
• Communicate with members regarding appeal statuses and educate them on the process
• Document all investigation and resolution processes accurately in the database

Required Qualifications

• Minimum of two years of experience in a health insurance environment, preferably in appeals and grievances
• Familiarity with state and federal regulations such as Medicare and ERISA is preferred
• Strong skills in Word and Excel, with the ability to research regulations
• High School diploma or equivalent required; Associate's degree preferred