Claims Appeals Specialist
Company: VirtualVocations
Location: Vista
Posted on: May 13, 2025
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Job Description:
A company is looking for a Claims Appeals Specialist.
Key Responsibilities
Investigate and resolve member and provider complaints, appeals,
disputes, and grievances
Utilize internal systems to research claims and determine outcomes
in compliance with regulations
Draft appeal summaries and communicate decisions to members and
providers
Required Qualifications
High School Diploma or GED required
Minimum 2 years of operational experience in managed care
Knowledge of Medicaid and Medicare regulatory guidelines
Experience with health claims processing
Keywords: VirtualVocations, Rancho Cucamonga , Claims Appeals Specialist, Other , Vista, California
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