Grievance Specialist

Job Summary

A company is looking for a Grievance Specialist to resolve member grievances with accuracy and compassion.

Key Responsibilities

• Maintain knowledge of products, benefits, policies, and procedures
• Conduct thorough investigations and ensure grievances are resolved within regulatory timelines
• Collaborate with internal partners to gather information and improve member experience

Required Qualifications

• Experience with Medicare Advantage appeals and grievances
• Strong attention to detail and commitment to data accuracy
• Ability to handle changing regulations and case volumes
• Strong time management and organizational skills
• Bachelor's degree or equivalent experience in healthcare or related field