Appeals Specialist

Title: Temp – Administrative – Appeals Specialist (Days) Flint, MI

Description: Responsible for assisting with coordination of all appeal/grievance activity for the Plan. Responsible for ensuring departmental compliance with applicable regulations and tracking appeal and grievance activity, complying with state and regulatory standards. Assists in preparing and researching case files as necessary. Responsible for research and resolution of member and provider claims issues. Responsible for assisting with member and provider education opportunities regarding complaints/grievances/appeals. Identifies process improvement opportunities and develops plans to address opportunities.