Appeals and Grievances Specialist
Company: VirtualVocations
Location: Baton Rouge
Posted on: January 21, 2025
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Job Description:
A company is looking for a Specialist, Appeals & Grievances.
Key Responsibilities
Review and resolve member and provider complaints in compliance
with regulatory standards
Research claims appeals and grievances, ensuring timely and
appropriate responses
Prepare appeal summaries and correspondence, documenting findings
and trends as necessary
Required Qualifications
High School Diploma or equivalency
Minimum 2 years of operational managed care experience
Experience in health claims processing, including coordination of
benefits and eligibility criteria
Familiarity with Medicaid and Medicare claims denials and appeals
processing
Keywords: VirtualVocations, Alexandria , Appeals and Grievances Specialist, Other , Baton Rouge, Louisiana
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