To support a growing remote team, the full-time Appeals and Grievance Specialist will manage and resolve complaints, grievances, and appeals from members and providers while ensuring compliance with applicable requirements. Key responsibilities Manage and resolve complaints, grievances, and appeals from members and providers Serve as the primary contact throughout the investigation and resolution process Conduct fair, accurate, and timely case investigations while maintaining documentation Required qualifications 1+ year of Medicare Appeals and Grievance or Medicare Claims experience required Experience with Medicare Part C or Part D preferred Familiarity with Windows-based computer systems High School Diploma or equivalent Strong technical and keyboarding skills
Appeals and Grievance Specialist in workfromhome at Unknown Company
This position is listed as full time and able to be worked remotely.