Appeals Analyst

5 days ago

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Logo of Highmark Health

Highmark Health

health care

10,000+

πŸ’° $5M Grant on 2021-05

Description

β€’ This job reviews inquiries to determine if they meet the definition of a grievance/appeal; β€’ documents, investigates, refers and coordinates grievances and appeals; β€’ initiates a case file for each grievance and appeal; β€’ ensures compliance with organizational and regulatory requirements for member or provider issues; β€’ independently coordinates the resolution with internal/external parties as required; β€’ documents and summarizes to all parties involved in the case the investigation results.

Requirements

β€’ Required 3-5 years of relevant, progressive experience in the area of specialization. β€’ Preferred Experience in Customer Service or a related field. β€’ Required High School Diploma or GED

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