Employer Industry: Healthcare Insurance

Why Consider this Job Opportunity:
- Competitive pay up to $77,000
- Opportunity for career advancement and growth within the organization
- Supportive and collaborative work environment
- Chance to make a positive impact on member and provider relations
- Excellent benefits package, including healthcare coverage and retirement plans
- Opportunity to work in a regulated industry and ensure compliance with all regulatory requirements

What to Expect (Job Responsibilities):
- Review and evaluate appeal and grievance requests to identify and classify member and provider appeals
- Provide written acknowledgment of member and provider correspondence
- Conduct thorough investigations of all member and provider correspondence
- Serve as a liaison with internal departments and external entities to ensure timely resolution of cases
- Prepare cases for medical and administrative review and accurately document findings

What is Required (Qualifications):
- Associate Degree in a related field; Bachelor's preferred
- 3+ years of related professional work experience required
- Excellent verbal and written communication skills required
- Proficiency in MS Office applications required
- Excellent problem-solving and analytical skills required

How to Stand Out (Preferred Qualifications):
- Customer service experience preferred
- Excellent product knowledge preferred
- Prior health industry and/or compliance work experience preferred

#HealthcareInsurance #CareerOpportunity #CompetitivePay #RegulatoryCompliance #CustomerService

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