Job Description
A company is looking for a Grievance & Appeals Resolutions Specialist III.
Key Responsibilities
Ensure full resolution of HICS and CTM cases within regulatory timeframes
Research and resolve discrepancies associated with membership eligibility
Analyze operations and suggest process improvements for HICS and CTM case resolution
Required Qualifications
Associate Degree in business, finance, or related field preferred
Minimum of three (3) years of customer service or claims experience required
Prior experience in managed care or healthcare industry preferred
Experience in enrollment, billing, finance, or data analysis preferred
Current, unrestricted State Insurance License in Accident and Health required
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