Appeal Specialist II

Job Summary

Under supervision, this position is responsible for processing and adjudicating complex non-utilization management appeals according to the appropriate federal, state, and NCQA requirements and regulations; and responding, by phone, in person, or in writing, to all inquiries involving member

• s requests for appeals. May train and mentor less experienced appeals specialists.

This role is hybrid in our Houston, TX office located at 8101 W Sam Houston Parkway S. The starting pay rate for this role is $22.50-$25.00 / hr based upon experience.

Job Requirements

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

Pay Transparency Statement :

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings.

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

HCSC Employment Statement :

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

Base Pay Range

$18.10 - $37.10

Exact compensation may vary based on skills, experience, and location.