Senior Policy and Appeals Specialist
GravieUnited States
Posted April 8, 2026
50400 - 84000 USD
Full Time
About the Company
Gravie is a company that creates health benefits for small and midsize businesses and their employees, with a mission to create a more equitable and sustainable future for employer-sponsored health insurance.
Job Description
Gravie is seeking a Senior Policy and Appeals Specialist to provide advanced-level expertise in appeals processing, responsible for the comprehensive review, investigation, and resolution of Member appeals and provider disputes for Gravie.
Requirements
- High School Diploma
- 6+ years of experience processing/adjusting and/or analyzing medical claims preferably in a TPA environment
- 3+ years of experience with medical appeals and provider disputes
- Ability to set priorities, manage time and work independently
- Basic proficiency using Windows-based computer applications
- Functional comfort with Zoom, Microsoft Teams, or Google Meets
- General knowledge of CMS claims submission regulations
- Demonstrated success getting results through collaboration
- Excellent facilitation and transferable knowledge skills communicating effectively on complex concepts
- Proven ability to develop and implement appeals and disputes processes
- Experience in managing and assigning claims inventory
Benefits
- Alternative medicine coverage
- Generous PTO
- Up to 16 weeks paid parental leave
- Paid holidays
- 401k program
- Transportation perks
- Education reimbursement
- Paid paw-ternity leave
