Appeals Specialist - job 1 of 2

Job Summary

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

Key Responsibilities

• Analyze and prioritize appeals and grievance requests, ensuring accurate data entry and case assignment
• Communicate with stakeholders to respond to appeals and grievances while maintaining confidentiality
• Assist in unit projects and provide feedback for continuous improvement of workflows related to appeals and grievances

Required Qualifications

• High School Diploma or GED
• 3 years of experience in managed care, health care, or insurance payor environments
• Preferred experience in Appeals and Grievances within a healthcare payor organization
• Knowledge of medical terminology
• Ability to meet deadlines and manage multiple customer service demands