Grievance/Appeals Analyst I at Elevance Health reviewing and processing non-complex grievances and appeals. Collaborating in a hybrid environment for a healthcare-focused company.
Responsibilities
Reviews, analyzes and processes non-complex grievances and appeals
Utilizes guidelines and review tools to conduct extensive research
Analyzes and renders determinations on assigned non-complex grievance and appeal issues
Serves as a liaison between grievances & appeals and medical management, legal, and operational departments
Requirements
HS diploma or GED
Minimum of 3 years experience working in grievances and appeals, claims, or customer service
Demonstrated business writing proficiency
Understanding of provider networks
Knowledge of the medical management process
Familiarity with claims process
Understanding of the company's internal business processes and technology
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