Remote Medicare Appeals & Grievances Specialist

Blue Cross and Blue Shield of Kansas; Topeka (KS); Hybrid; USD 38.000 - 45.000; Vollzeit

Benefits dieser Stelle

Incentive pay program (EPIP)

Health/Vision/Dental insurance

6 weeks paid parental leave for new母s

Fertility/Adoption assistance

2 weeks paid caregiver leave

401(k) plan matching up to 5%

Tuition reimbursement

Health & fitness benefits, discounts

Zusammenfassung

Blue Cross and Blue Shield of Kansas is seeking a MA Appeals and Grievances Specialist to deliver world-class customer service through processing and resolution of MA member, member representative, or provider appeals and grievances. You may also handle inquiries related to MA benefits and plan changes.

This role can be remote or onsite, with residency in Kansas or Missouri or willingness to relocate. It requires strong communication, analytical and research skills, and a commitment to

Qualifikationen

• Ability to interact positively with internal and external customers while demonstrating empathy, adaptability, and listening skills.
• Ability to listen, research, and communicate effectively across channels.
• Ability to apply reasoning, analytical, and problem-solving skills and sound judgment.
• Ability to conduct extensive research and provide analyses and solutions to issues.

Aufgaben

• Process MA member, member representative or provider appeals and grievances to ensure regulatory guidelines are met.
• Interpret MA benefit offerings and corporate policies to address issues.
• Develop relationships with staff, providers, and members to facilitate timely resolution of cases.
• Serve as backup to MA Customer Experience Representatives as needed.

Jobbeschreibung

Blue Cross and Blue Shield of Kansas is seeking a MA Appeals and Grievances Specialist to deliver world-class customer service through processing and resolution of MA member, member representative, or provider appeals and grievances. You may also handle inquiries related to MA benefits and plan changes.

This role can be remote or onsite, with residency in Kansas or Missouri or willingness to relocate. It requires strong communication, analytical and research skills, and a commitment to