Appeals Specialist I

Working remotely, the full-time Appeals Specialist I will analyze appeals and grievance correspondence, manage information tracking, and facilitate the processing of appeals for the Commercial line of business. Key responsibilities Prioritize and analyze appeal and grievance requests, ensuring accurate data entry and compliance with processing guidelines Communicate with internal and external stakeholders to request documentation and provide updates on appeals and grievances Assist with unit projects and continuous improvement initiatives related to the appeals and grievance processes Required qualifications High School Diploma or GED 3 years of experience in managed care, health care, or insurance payor environments Knowledge of medical terminology Strong organizational and analytical skills Ability to meet deadlines and manage multiple customer service demands