Medical Biller & Coder

Job Title: Grievance & Appeals Specialist I

Location: Meridian, ID 83642

Pay Range : $25/hr - $27/hr

Duration: 6 Months Contract

Job Description:

Our Grievance & Appeals Specialist I act as the primary investigator for member appeals and grievances including analyzing, researching, and managing inventories.

Responding to member/provider requests within regulatory requirements and plan policy.

We're looking for Grievance & Appeals Specialist I with:

Required Experience: 3 years’ health industry or related experience

What a day of a Grievance & Appeals Specialist I would look like:

• Ensure cases are accurately classified and categorized.
• Prepare comprehensive case histories for presentation and consideration at committee meetings and audits.
• Determines if additional information or documentation is needed to make appropriate decisions.
• Interpret and apply business rules, policies and contract.
• Prepare appeal cases to send to an independent specialty reviewer.
• Present appeal case information to a multi-department committee.

Additional skills that we are looking for:

• Good verbal and written communication skills
• Medical terminology
• Familiar with ICD10 and CPT coding
• Experience with Individual and Group Contract language
• Customer Service or Claims processing experience preferred

Dexian stands at the forefront of Talent + Technology solutions with a presence spanning more than 70 locations worldwide and a team exceeding 10,000 professionals. As one of the largest technology and professional staffing companies and one of the largest minority-owned staffing companies in the United States, Dexian combines over 30 years of industry expertise with cutting-edge technologies to deliver comprehensive global services and support.

Dexian connects the right talent and the right technology with the right organizations to deliver trajectory-changing results that help everyone achieve their ambitions and goals. To learn more, please visit