Senior Appeals Analyst

Highmark Health

Base: $23.16 - $35.88; bonus/equity: not specified...
Review inquiries for grievance/appeal definition
Investigate and coordinate resolutions
Ensure regulatory compliance
The Appeals Analyst reviews inquiries to determine if they meet the definition of a grievance/appeal

Job Summary

  • The Appeals Analyst reviews inquiries to determine if they meet the definition of a grievance/appeal.
  • This role independently coordinates the resolution with internal/external parties as required and documents investigation results.
  • The position requires participation in workgroup meetings to address trends and work on process improvement initiatives with cross-functional teams.

Matching Summary

The Appeals Analyst reviews inquiries to determine if they meet the definition of a grievance/appeal.

Salary

Base: $23.16 - $35.88; Bonus/Equity: Not specified; Benefits: Not specified

Skills & Requirements

Must-have

  • Review inquiries for grievance/appeal definition
  • Investigate and coordinate resolutions
  • Ensure regulatory compliance
  • Document investigation results
  • Participate in workgroup meetings

Nice-to-have

  • Experience in customer service
  • Knowledge of multiple processing systems
  • Ability to interpret government regulations

Key Requirements

  • High School Diploma or GED
  • 5-10 years of relevant experience
  • Knowledge of claims processing methodologies
  • Knowledge of company products
  • Excellent organizational skills
  • Strong verbal and written communication skills

Work Rights

Not specified

Tailored Resume

Cover Letter