Appeals Specialist - Fresno California

Company: VirtualVocations
Location: Fresno, California
Posted On: 02/01/2025

A company is looking for an Appeals & Complaints Specialist I to review, analyze, and process complaints and appeals regarding dental and vision services.



Key Responsibilities

Analyze, research, and process appeal requests from members and providers regarding denied clinical services and/or payment
Resolve complaints and grievances filed by members or providers regarding dental and/or vision benefit provisions or care
Document all appeal, complaint, and grievance activity for reporting and trending analysis


Required Qualifications, Training, and Education

High school diploma or equivalent required
1+ years of job-related experience such as accounting, billing, or insurance
1+ years of experience interacting with customers and clients
Knowledge of general computer software, including Outlook, Excel, and MS Word
Ability to work overtime as needed More...

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