Appeals Specialist
Appeals Specialist
Posted on :
14-04-2025
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1 Vacancy
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Job Description
Position Appeal/grievance Specialist
Facility McLaren Health Plan
Address G3245 Beecher Rd Flint MI 48532
Contract 13 weeks
Shift 8:30am5:00pm
Contract 24 weeks
This is a fully remote position
Job Description
Responsible for assisting with coordination of all appeal/grievance activity for the Plan. Responsible for ensuring departmental compliance with applicable regulations and tracking appeal and grievance activity complying with state and regulatory standards. Assists in preparing and researching case files as necessary. Responsible for research and resolution of member and provider claims issues. Responsible for assisting with member and provider education opportunities regarding complaints/grievances/appeals. Identifies process improvement opportunities and develops plans to address opportunities.
Facility McLaren Health Plan
Address G3245 Beecher Rd Flint MI 48532
Contract 13 weeks
Shift 8:30am5:00pm
Contract 24 weeks
This is a fully remote position
Job Description
Responsible for assisting with coordination of all appeal/grievance activity for the Plan. Responsible for ensuring departmental compliance with applicable regulations and tracking appeal and grievance activity complying with state and regulatory standards. Assists in preparing and researching case files as necessary. Responsible for research and resolution of member and provider claims issues. Responsible for assisting with member and provider education opportunities regarding complaints/grievances/appeals. Identifies process improvement opportunities and develops plans to address opportunities.
Employment Type
Full Time
Key Skills
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