Appeals Specialist

France Cars SAS AAA(2 months ago)

FloridaOnsiteFull TimeMedior$51,000 - $80,070Appeals & Grievances

About this role

The Appeals Specialist in the Appeals & Grievances unit is a subject matter expert responsible for non-clinical case development and resolution of member and non-contracted provider appeals across Health Plan lines of business. The role ensures compliance with federal and state regulations, manages an independent caseload, and is accountable for investigating and resolving initiated cases.

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Required Skills

Case Development
Case Resolution
Regulatory Compliance
Claims Processing
Appeals Management
Critical Thinking
Decision Making
Attention To Detail
Communication
Time Management

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Qualifications

HS Diploma or GED
Bachelor's Degree (Preferred)

About France Cars SAS AAA

bloomberg.com

Bloomberg is a global leader in financial information and technology, providing data, news, and analytics to financial professionals around the world. The company offers an array of products and services, including the Bloomberg Terminal, which delivers real-time data and insights for trading, investment, and risk management. With a commitment to innovation, Bloomberg combines cutting-edge technology with extensive market expertise to empower financial professionals in making informed decisions.

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