Specialist, Appeals & Grievances (Member Medicaid/Marketplace experience)

Provides support for claims activities, including reviewing and resolving member and provider complaints, and communicating resolution to members or authorized representatives.

Requirements

• At least 2 years of managed care experience in a call center, appeals, and/or claims environment
• Health claims processing experience, including coordination of benefits (COB), subrogation and eligibility criteria
• Customer service experience
• Strong organizational and time management skills; ability to manage simultaneous projects and tasks to meet internal deadlines
• Effective verbal and written communication skills
• Microsoft Office suite/applicable software program(s) proficiency

Benefits

• Competitive benefits and compensation package