Humana
Supervisor, Grievances & Appeals
This job is now closed
Job Description
- Req#: R-321280
Employer Industry: Healthcare Insurance
Why Consider this Job Opportunity:
- Remote work opportunity with occasional on-site training, meetings, and conferences
- Competitive pay up to $87,400 per year
- Opportunities for professional development and continued education
- Comprehensive benefits package, including medical, dental, and vision coverage
- Chance to work for a Fortune 100 company with a focus on associate engagement and well-being
- Supportive work environment with a commitment to improving consumer experiences
What to Expect (Job Responsibilities):
- Manage client medical denials by conducting comprehensive analytic reviews of clinical documentation
- Determine if an appeal is warranted and collaborate with management and specialists to select appropriate methods and techniques
- Supervise a team of associates assisting members and providers with appeal resolutions
- Ensure consistency in execution across the team and hold team members accountable for following established policies
- Support quality-related goals and perform escalated or more complex work as needed
What is Required (Qualifications):
- Minimum of 2 years of experience in a Supervisor or Team Lead capacity
- Minimum 2 years of customer service experience within the healthcare industry
- Advanced proficiency in Microsoft Office programs, including Word, Excel, and Outlook
- Experience working in a high-volume production environment
- Previous experience with coordinating and leading projects and tasks
- Excellent written, verbal, and electronic communication skills
How to Stand Out (Preferred Qualifications):
- Grievance & Appeals or claims experience
- Bachelor's Degree
- Proficiency in Microsoft PowerPoint and/or Access
- Ability to create professional Microsoft PowerPoint presentations
- General understanding of healthcare economic, financial, and operational concepts
#HealthcareInsurance #RemoteWork #CompetitivePay #ProfessionalDevelopment #Fortune100About the company
Humana looks at every facet of your life and works with you to create a path to health that fits your unique needs
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