Grievance & Appeals Analyst - Remote (Entry Level)

Elevance Health; Rancho Cordova (CA); Hybrid; USD 43,000 - 59,000; Full time

Benefits offered by this job

Health benefits

401(k)

HSA

Job summary

Elevance Health is seeking an entry-level analyst for the Enterprise Grievance & Appeals Department in California. The role reviews non-complex grievances and appeals from members and providers across multiple plans, applying standards to reach appropriate determinations.

The position requires a HS diploma or GED and strong business writing, communication, and analytical skills. The analyst may liaise with medical staff and other departments as part of the review process.

Qualifications

• HS diploma or GED is required.
• Strong business writing proficiency.
• Understanding of provider networks and medical management processes preferred.

Responsibilities

• Review and process non-complex grievances and appeals.
• Research and analyze issues using guidelines and claims/medical records.
• Render determinations and prepare written communications of the decision.
• Coordinate with nursing/medical staff and other departments as needed.

Skills

Business writing

Grievances & appeals knowledge

Communication skills

Analytical skills

Problem solving

Education

High school diploma or GED

Job description

Elevance Health is seeking an entry-level analyst for the Enterprise Grievance & Appeals Department in California. The role reviews non-complex grievances and appeals from members and providers across multiple plans, applying standards to reach appropriate determinations.

The position requires a HS diploma or GED and strong business writing, communication, and analytical skills. The analyst may liaise with medical staff and other departments as part of the review process.