Appeals and Grievances Specialist

Our client is looking for a focused and organized Appeals & Grievances Specialist to join their team. In this role, you will research and resolve claims issues for members and healthcare providers. This is a great position for someone who enjoys working independently and digging into details to solve problems. ***Must be flexible to work Arizona timezone***

salary: $20 - $21 per hour
shift: First
work hours: 8 AM - 5 PM
education: High School

Responsibilities

• Research Claims: Look into why a claim or service was denied or paid incorrectly.
• Manage Cases: Take an appeal from start to finish, making sure all steps are completed.
• Write Letters: Create and send formal letters to members and providers to explain the final decision.
• Collaborate: Work on your own daily tasks while staying in touch with your team and other departments.
• Meet Goals: Aim to close at least 3 cases per day with a 98% accuracy rate .

Skills

• appeals
• Claims Processing
• Amysis
• Written Communication

Qualifications

• Years of experience: 2 years
• Experience level: Experienced

Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.

Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact [email protected].

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).

This posting is open for thirty (30) days.

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.