Grievances & Appeals Specialist I
Meridian - Mainonsitemid
Posted 1mo ago · via Workday
About this role
Our Grievance & Appeals Specialist I act as the primary investigator for member appeals and grievances including analyzing, researching, and managing inventories. Responding to member/provider requests within regulatory requirements and plan policy. We're looking for Grievance & Appeals Specialist I with: Required Experience: 3 years’ health industry or related experience What a day of a Grievance & Appeals Specialist I would look like: Ensure cases are accurately classified and categorized. Prepare comprehensive case histories for presentation and consideration at committee meetings and audits. Determines if additional information or documentation is needed to make appropriate decisions. Interpret and apply business rules, policies and contract.…
What we'd score you on
reqspace match rubricFive dimensions, recruiter-grade. Upload your resume and we'll generate a written explanation of where you fit and where the gaps are.
1
Skills match
We compare your skills against the role requirements.
2
Level fit
This role is mid-level. We check your trajectory against it.
3
Domain experience
Your work in the role's domain matters more than your years total. We weight recent and direct experience.
4
Recency
A skill you used last quarter weighs more than one from five years ago. We grade on recency, not lifetime.
5
Location fit
This role is based in Meridian - Main. We weight your proximity and willingness to relocate.
Score yourself on this role.
Free · no card · written explanation included
More at Bcidaho
- View →Sales ExecutiveMeridian - Main
- View →Payment Integrity Quality Program Implementation Specialist I or IIMeridian - Main
- View →Project Manager I/II (Enterprise Transformation Office)Meridian - Main
- View →IT Applications EngineerMeridian - Main
- View →Senior Tax ManagerMeridian - Main
- View →Procurement Manager IIMeridian - Main