Appeals and Grievance Specialist
Presbyterian Healthcare Services(1 month ago)
About this role
An Appeals and Grievance Specialist at Presbyterian Healthcare Services supports the health plan by managing member and provider grievances, complaints, and appeals. The role focuses on ensuring regulatory-compliant case documentation, accurate reporting, and advocacy for members within the organization. This is a full-time position based in Albuquerque.
Required Skills
- Appeals
- Grievance Handling
- Complaint Resolution
- Research
- Documentation
- Communication
- Customer Service
- Regulatory Compliance
- Case Management
- Claims Processing
Qualifications
- High School Diploma or GED
- Associate 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.
View more jobs at Presbyterian Healthcare Services →Apply instantly with AI
Let ApplyBlast auto-apply to jobs like this for you. Save hours on applications and land your dream job faster.
More jobs at Presbyterian Healthcare Services
Similar Jobs
Appeals & Grievances Coordinator
Brigham and Women(1 month ago)
Appeals and Grievance Specialist - Work from Home
Sagility(26 days ago)
Grievance/Appeals Representative I
Elevance Health(8 days ago)
Grievance Specialist
France Cars SAS AAA(2 months ago)
Appeals Specialist
France Cars SAS AAA(2 months ago)
Appeals & Grievances Coordinator
Brigham and Women(1 month ago)