Grievance and Appeal Specialist
Company: VirtualVocations
Location: Port Saint Lucie
Posted on: April 6, 2025
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Job Description:
A company is looking for a Grievance & Appeal Specialist.
Key Responsibilities
Conduct and document thorough investigations of grievances,
complaints, and appeals
Ensure accurate documentation of cases in the appeals management
system and maintain compliance with reporting requirements
Communicate resolutions to members, providers, and clients
effectively
Required Qualifications
High school diploma/GED required; Bachelor's degree in a related
field preferred
Two plus years of appeals and grievance experience or related
experience required
Broad knowledge of plan products, processes, and enrollment
rules
Ability to perform research and evaluate documentation
requirements
Familiarity with compliance reporting and data validation
requirements
Keywords: VirtualVocations, Pembroke Pines , Grievance and Appeal Specialist, Other , Port Saint Lucie, Florida
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