Appeals Specialist II

Job Summary

A company is looking for an Appeals Specialist II, (Remote).

Key Responsibilities

• Conduct initial analysis of appeals/grievance correspondence and determine next steps
• Research contractual benefits and assist in the review of complex grievances and appeals
• Interact with internal and external stakeholders while maintaining confidentiality and mentor entry-level associates

Required Qualifications

• High School Diploma or GED
• 5 years of experience in managed care, health care, or insurance payor environment
• 2 years of experience in Appeals and Grievance Management
• Previous experience in an appeals and grievance department is preferred
• Knowledge of medical terminology