Grievance and Appeals Specialist

Job Summary

A company is looking for a Grievance & Appeals Specialist II to review appeals submitted by Medicaid and Medicare providers.

Key Responsibilities

• Prepare and track appeals for clinical review
• Review and validate submitted appeals daily
• Document outcomes of claims appeals and maintain records of all appeals reviewed

Required Qualifications

• High school diploma or equivalent is required
• Associates Degree or equivalent relevant work experience preferred
• Minimum of two (2) years of healthcare customer service, claims, compliance, or related experience is required