Job Title

Job Description

Process appeals and grievances, analyze, research, and provide comprehensive responses in accordance with established regulatory and accreditation guidelines. Contact customers to gather information and communicate disposition of case. Conduct pertinent research in order to evaluate, respond to, and finalize case. Familiar with standard concepts, practices, and procedures for analyzing, interpreting data and applying contract and regulatory provisions. This is a Remote Role Experience Experience handling a large load of work in a fast-paced environment. Insurance, Medicare/Client knowledge Writing Letters Analytical thinker & Research Skills Grievance and Appeals experience. Experience in analyzing a claim Experience in classification between a grievance/appeal/organizational determination. Education Prefer a Bachelor's Degree EEO Employer LanceSoft is a certified Minority Business Enterprise (MBE) and an equal opportunity employer. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws. This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall, leave of absence, compensation, benefits, training, and apprenticeship. LanceSoft makes hiring decisions based solely on qualifications, merit, and business needs at the time. Experience: 3 years required