Grievance/Appeals Analyst I
Elevance Health
full-time
Posted on:
Location Type: Hybrid
Location: Columbus • California, Florida, Ohio • 🇺🇸 United States
Visit company websiteSalary
💰 $23 - $34 per hour
Job Level
Mid-LevelSenior
About the role
- Reviews, analyzes and processes non-complex grievances and appeals in accordance with external accreditation and regulatory requirements
- Utilizes guidelines and review tools to conduct extensive research and analyze the grievance and appeal issue(s)
- Analyzes and renders determinations on assigned non-complex grievance and appeal issues and completion of the respective written communication documents to convey the determination
- The analyst may serve as a liaison between grievances & appeals and /or medical management, legal, and/or service operations and other internal departments
Requirements
- HS diploma or GED
- Minimum of 3 years experience working in grievances and appeals, claims, or customer service
- understanding of provider networks
- understanding of the medical management process
- understanding of claims process
- understanding of the company's internal business processes
- understanding of internal local technology
Benefits
- a comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
- paid time off
- medical benefits
- dental benefits
- vision benefits
- short and long term disability benefits
- wellness programs
- financial education resources
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
grievances and appeals analysisclaims processingcustomer service
Soft skills
communicationanalytical thinkingliaison skills
Certifications
HS diplomaGED