Appeals Specialist

Job Summary

A company is looking for an Appeals Specialist II.

Key Responsibilities

• Supports documentation and processing of appeals, disputes, and reconsiderations to ensure compliance with state and NCQA requirements
• Reviews and investigates appeals requests to determine appropriate follow-up and ensures timely processing
• Prepares correspondence and maintains documentation files related to appeals, disputes, and reconsiderations

Required Qualifications

• High School diploma or GED
• 1-2 years of related experience
• Knowledge of appeals process preferred