Grievance & Appeals Analyst I (Entry-Level)

Mindlance; Indianapolis (IN); On-site; USD 22,000 - 33,000; Full time

Job summary

SmartRecruiters, Inc. seeks an entry level Grievance/Appeals Rep I in Indianapolis, IN to review and process non-complex grievances and appeals from members, providers and others, following regulatory and internal guidelines.

Requires a High school diploma or GED and 3–5 years in grievances, claims, or customer service. Strong medical terminology, basic coding, and clear business writing are essential for written determinations and interdepartmental liaison.

Qualifications

• Requires a High school diploma or GED; 3 to 5 years' experience in grievances/appeals, claims, or customer service.
• Familiarity with medical coding and medical terminology.
• Understanding of provider networks and medical management/claims processes.
• Proficient business writing; able to communicate clearly in writing.

Responsibilities

• Review and process non-complex grievances and appeals per policy.
• Research claims and medical records to determine determinations.
• Prepare written communications conveying determinations.
• Coordinate with nursing/medical staff as needed.
• Serve as liaison between departments.

Skills

Medical coding basics

Medical terminology

Business writing

Provider networks understanding

Education

High school diploma or GED

Job description

SmartRecruiters, Inc. seeks an entry level Grievance/Appeals Rep I in Indianapolis, IN to review and process non-complex grievances and appeals from members, providers and others, following regulatory and internal guidelines.

Requires a High school diploma or GED and 3–5 years in grievances, claims, or customer service. Strong medical terminology, basic coding, and clear business writing are essential for written determinations and interdepartmental liaison.