Appeals Specialist I

Job Summary

A company is looking for an Appeals Specialist I (remote).

Key Responsibilities

• Prioritize, research, and analyze information for appeals and grievances, ensuring accurate data entry and case assignment
• Assist in responding to appeals in compliance with State and Federal regulations while maintaining confidentiality
• Support unit projects and provide feedback for workflow improvements during monthly meetings

Required Qualifications

• High School Diploma or GED
• 3 years of experience in managed care, health care, or insurance payor environments
• Previous experience in an appeals and grievance department is preferred
• Knowledge of medical terminology
• Strong organizational and analytical skills