Appeals and Grievance Specialist
Presbyterian Healthcare Services(1 month ago)
About this role
An Appeals and Grievance Specialist at Presbyterian works within the health plan to manage member and provider appeals and grievances, supporting compliance and reporting across the organization. The full-time role is based in Albuquerque at the administrative center and contributes to improving member experience within a not-for-profit healthcare system.
Required Skills
- Research
- Complaint Handling
- Appeals Management
- Grievance Resolution
- Documentation
- Customer Service
- Communication
- Regulatory Compliance
- Medical Records
Qualifications
- High School Diploma or GED
- Associates Degree (Preferred)
About Presbyterian Healthcare Services
phs.orgFind the medical care and health plan you and your family need at Presbyterian Healthcare Services, an integrated system of hospitals, healthcare providers and insurance plans serving patients and members in New Mexico.
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