Grievance & Appeals Specialist I

Centene Corporation
Pittsburgh, PA
Category Healthcare
Job Description
As a Grievance & Appeals Specialist I, you will be responsible for reviewing, investigating, and tracking member grievances and appeals, and provider claims disputes. You will coordinate with the G&A Administrator and outside counsel during state fair hearing proceedings and manage daily entries into the DBHS Office of Grievance and Appeals database.

Requirements

  • Bachelor’s degree or equivalent in a related field
  • 2+ years of behavioral health or physical health experience
  • Experience processing grievances and appeals preferred
  • PA Health and Wellness only: 1-2 Years of related experience required

Benefits

  • Competitive pay
  • Health insurance
  • 401K and stock purchase plans
  • Tuition reimbursement
  • Paid time off plus holidays
  • Flexible work schedule
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