Senior Appeals Examiner

This is a fully remote position, open to applicants in Florida, +4 more states.

📋 Description

• Oversee the resolution of complaint and appeal situations for all products.

• Provide timely and customer-centric responses to complaints and appeals.

• Recognize trends and emerging issues, reporting them along with recommended solutions.

• Analyze and review complex appeals.

• Facilitate the interpretation of policy and coverage guidelines.

• Coordinate reviews as necessary.

• Draft all resolution letters.

• Support the coaching and mentoring of fellow analysts.

• Assist with external reviews as required.

⛳️ Requirements

• A minimum of 1 year of experience in healthcare, specifically in appeals, claims, and/or compliance.

• At least 1 year of experience with plan documents, claims research, and/or letter writing.

• Proficient knowledge of Microsoft Office applications (Word, Excel, PowerPoint, Outlook).

🏝️ Benefits

• Medical, dental, and vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Comprehensive benefits package.