Appeals Representative

Job Summary

A company is looking for an Appeals Representative Sr.

Key Responsibilities

• Research and resolve written complaints from consumers and providers
• Ensure proper categorization of complaints and obtain necessary documentation for case review
• Communicate appeal or grievance information to members or providers within required timeframes

Required Qualifications

• High School Diploma / GED or equivalent work experience
• Must be 18 years of age or older
• 2+ years of experience in analyzing and solving appeals and grievances or in a healthcare setting
• Experience with Microsoft Word and Excel
• Ability to work flexible hours, including Monday to Saturday shifts