Appeals Representative

A company is looking for an Appeals Representative to manage consumer and provider complaints.

Key Responsibilities

Research and resolve written complaints from consumers and physicians / providers

Ensure proper categorization of complaints and obtain necessary documentation for case review

Communicate appeal or grievance information to members or providers within required timeframes

Required Qualifications

High School Diploma / GED or equivalent work experience

Must be 18 years of age or older

1+ years of experience in analyzing and solving customer problems or related work experience

Proficiency with computer and Windows PC applications

Ability to work full-time with flexibility for 8-hour shifts during business hours