Let’s get started
Company Logo

Remote Jobs

Appeals and Grievances Analyst

7/15/2025

N/A

Job Summary

A company is looking for an Appeals & Grievances Analyst.

Key Responsibilities
  • Manage and coordinate member appeals and grievances in compliance with regulatory requirements
  • Prepare cases for presentation to the Member Appeals Committee and provide written documentation of final dispositions
  • Consult with subject matter experts and gather necessary documentation to resolve appeals and grievances
Required Qualifications, Training, and Education
  • Associate's Degree or equivalent experience in health care or conflict resolution; Bachelor's Degree preferred
  • 2-4 years of experience in customer service or member services within health care or insurance; 2 years of Appeals and Grievance experience preferred
  • Knowledge of health care benefits and regulatory requirements preferred
  • Proficiency in using computer applications, including Windows
  • Ability to work independently and manage multiple tasks efficiently

Comments

No comments yet. Be the first to comment!