The Grievances & Appeals Representative 2 triages Medicaid and AIP (dual) expedited cases and reviews clinical documentation to determine if a grievance or appeal is warranted
Job Summary
The Grievances & Appeals Representative 2 triages Medicaid and AIP (dual) expedited cases and reviews clinical documentation to determine if a grievance or appeal is warranted.
This is an extremely high-volume, fast-paced role, with the responsibility of moving several cases per hour.
Humana offers competitive benefits that support whole-person well-being, including medical, dental and vision benefits, 401(k) retirement savings plan, and time off.
Matching Summary
The Grievances & Appeals Representative 2 triages Medicaid and AIP (dual) expedited cases and reviews clinical documentation to determine if a grievance or appeal is warranted.
Salary
$40,000 - $52,300 per year
Skills & Requirements
Must-have
Medicaid and AIP (dual) expedited cases
Review clinical documentation
Proactive queue management
Attention to changing processes
Handle support requests across multiple workstreams
Effective communication with leadership
Nice-to-have
Experience with production and meeting metrics
Comfortability working across multiple software systems
Key Requirements
1+ years of customer service experience
Intermediate experience with Microsoft Office programs
Associate or bachelor's Degree
Previous inbound call center or related customer service experience