Appeals Specialist
Humana
Humana Inc. is seeking a Grievances & Appeals Representative 3 to manage member and provider denials, conduct analytic reviews of documentation, and determine if a grievance or appeal is warranted. You will deliver final determinations with clinical partnerships and strong initiative. Responsibilities include assisting members by phone, resolving Medicare/Medicaid claims issues, meeting QA metrics, and prioritizing tasks with discretion while working from a remote setting. #J-18808-Ljbffr
Vacancy posted 1 day ago
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