Appeals and Grievance Analyst
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Job Description
Member Appeals and Grievance Analyst managing member appeals and grievances at Point32Health. Ensuring compliance with state and federal regulations while advocating for members' needs.
Responsibilities:
- Act as a member advocate
- Manage assigned member appeals and grievance cases
- Ensure final disposition of appeals is compliant with regulatory requirements
- Consult with subject matter experts as necessary
- Make recommendations on appeal decisions based on member’s benefits
Requirements:
- Ability to learn and apply Point32Health’s policies
- Superior customer service and benefit interpretation skills
- Ability to appropriately handle multiple functions
- Ability to prioritize tasks and seek assistance when necessary
Benefits:
- Medical, dental and vision coverage
- Retirement plans
- Paid time off
- Employer-paid life and disability insurance with additional buy-up coverage options
- Tuition program
- Well-being benefits
- Full suite of benefits to support career development, individual & family health, and financial health
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