Remote Appeals Analyst – Health Insurance

Blue Cross and Blue Shield of Kansas City; Missouri; Hybrid; USD 60,000 - 75,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401(k) with employer contribution

Annual incentive bonus

Job summary

Blue Cross and Blue Shield of Kansas City is seeking an Appeals Analyst to process complaints, grievances and appeals from members and providers. The role supports timely, accurate responses consistent with SOPs and regulatory requirements.

The position offers work-from-home flexibility with leadership approval, plus a comprehensive rewards package including medical, dental, vision, 401(k) and paid time off.

Qualifications

• Bachelor’s degree in business, finance, accounting, law, health care administration, or other relevant academic discipline; OR four (4) years relevant experience in the health insurance industry
• 1-3 years of experience at a health insurer researching and responding to customer claim / benefit issues, or a related role providing a working knowledge of health plan benefits, major business systems and operational processes

Responsibilities

• Gather and review information to determine appropriate resolution of complaints, grievances and appeals
• Develop timely, accurate responses to complaints, grievances and appeals
• Ensure responses comply with SOPs, federal/state requirements and accreditation standards
• Communicate follow-up actions to operational areas and ensure timely completion

Skills

Effective communication

Professional writing

Customer service knowledge

Education

Bachelor’s degree in business/finance/Accounting/law/health care administration

4 years health insurance industry experience

Tools

Facets

ITS Host

Home ITS

Job description

Blue Cross and Blue Shield of Kansas City is seeking an Appeals Analyst to process complaints, grievances and appeals from members and providers. The role supports timely, accurate responses consistent with SOPs and regulatory requirements.

The position offers work-from-home flexibility with leadership approval, plus a comprehensive rewards package including medical, dental, vision, 401(k) and paid time off.