Director of Appeals and Grievances

VirtualVocations
Alpharetta, Georgia, United States
Full-time
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A company is looking for a Director of Appeals and Grievances.Key ResponsibilitiesManage a large Appeals and Grievance team and ensure compliant processing of casesConduct training, identify improvement opportunities, and ensure audit activities are performedOversee the timely processing of Appeals and Grievances while meeting Service Level AgreementsRequired Qualifications, Training, and EducationBachelor's degree in business administration, healthcare, or related field;

Master's degree preferredAt least 10 years of experience in a supervisory or management role, preferably in healthcare or insuranceMinimum of 5 years of experience in a grievance and appeals environment with knowledge of CMS regulationsExperience in medical benefits and healthcare industry regulationsCertification or progress toward certification in a relevant field is highly preferred

3 days ago
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