Senior Appeals Analyst

Highmark Health

Multiple Locations, US
$23.16 - $35.88; not specified; not specified ph
Grievance and appeal review
Case file initiation and documentation
Investigate and coordinate resolution
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 documents, investigates, refers, and coordinates grievances and appeals, ensuring compliance with organizational and regulatory requirements.
  • The position involves coordinating resolution with internal/external parties and documenting investigation results.

Matching Summary

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

Salary

$23.16 - $35.88; Not specified; Not specified

Skills & Requirements

Must-have

  • Grievance and appeal review
  • Case file initiation and documentation
  • Investigate and coordinate resolution
  • Regulatory compliance
  • Cross-functional team collaboration

Nice-to-have

  • Process improvement initiatives
  • Quality assurance support
  • Excellent organizational skills
  • Strong communication skills

Key Requirements

  • High School Diploma or GED
  • 5-10 years relevant experience
  • Knowledge of multiple processing systems
  • Knowledge of claims processing
  • Ability to interpret government regulations

Work Rights

Not specified

Tailored Resume

Cover Letter