Grievance/Appeals Analyst II for Elevance Health reviewing and processing appeals requests. Requires past experience in grievances and appeals handling in the healthcare sector.
Responsibilities
Responsible for reviewing, analyzing and processing non-complex and some complex pre service and post service grievances and appeals requests
Utilize guidelines and review tools to conduct extensive research and analyze the grievance and appeal issue(s)
Strictly follow department guidelines and tools to conduct reviews
Serve as a liaison between grievances & appeals and medical management, legal, and/or service operations
Requirements
HS diploma or equivalent
Minimum of 1 year of Grievance & Appeals analyst experience
Minimum of 3 years experience working in grievances and appeals, claims, or customer service
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