Texas Licensed Appeals Analyst - Columbus Ohio

Company: VirtualVocations
Location: Columbus, Ohio
Posted On: 02/03/2025

A company is looking for an Appeals and Grievance Analyst who will manage and coordinate member appeals and grievances in compliance with regulations.



Key Responsibilities

Act as a member advocate by communicating the appeal and grievance process
Manage member appeals and grievance cases from documentation to resolution
Review and interpret product and benefit designs according to regulatory requirements


Qualifications

Associates Degree or equivalent experience in health care or conflict resolution
3-5 years of health care or insurance experience
Preferred knowledge of health care benefits and regulatory requirements
Experience with insurance products, policies, and procedures is preferred
Ability to work independently and collaboratively as part of a team More...

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