A company is looking for a Grievance & Appeals Specialist III to process and respond to claim appeals and disputes while providing subject matter expertise.
Key ResponsibilitiesReview and process various types of appeals, ensuring accuracy and compliance with regulationsPrepare clinical review packets and document outcomes within the claims systemCollaborate with multiple departments to resolve grievances and ensure timely processingRequired Qualifications, Training, and EducationHigh school diploma or equivalent requiredAssociates Degree or equivalent relevant work experience preferredMinimum of three years of healthcare customer service, claims, compliance, or related experience requiredAt least one year of coding experience is requiredCertified Medical Coder (CPC, RHIT, or RHIA) is preferred
Appeals and Grievances Specialist
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Remote Administrative Assistant (No Experience Required) - Earn $25/hr-$45/hr, Full-Time/Part-Time, Flexible hours
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