Remote Senior SCA Appeals Specialist

Elevance Health, Inc.; Indianapolis (IN); Híbrido; USD 32.000 - 48.000; Jornada completa

Descripción de la vacante

Elevance Health is seeking a Sr. SCA Appeals Representative to support federal program grievances and appeals. The role is remote/hybrid within the United States, with required in-person training sessions and onboarding.

You will triage inquiries, prepare case files, and coordinate with clinical, legal, and regulatory stakeholders to resolve issues efficiently. Minimum requirements include a high school diploma and at least 4 years in grievances/appeals, along with strong communication skills

Formación

• Requires high school diploma or equivalent plus 4+ years in grievances/appeals.
• Strong written and verbal communication skills.
• Ability to investigate, summarize, and recommend resolutions.

Responsabilidades

• Triages clinical and non-clinical inquiries, grievances, and appeals.
• Prepares case files for member grievance committees/hearings.
• Summarizes information for clinical specialists, medical directors, and legal counsel.
• Responds to oral and written complaints.
• Ensures timely resolution within regulatory/accreditation timeframes.
• Documents interactions and dispositions in tracking systems.
• Provides guidance to other team members and participates in training.

Conocimientos

Grievances & appeals

Verbal & written communication

Research & case prep

PC proficiency

Educación

High school diploma or equivalent

Descripción del empleo

Elevance Health is seeking a Sr. SCA Appeals Representative to support federal program grievances and appeals. The role is remote/hybrid within the United States, with required in-person training sessions and onboarding.

You will triage inquiries, prepare case files, and coordinate with clinical, legal, and regulatory stakeholders to resolve issues efficiently. Minimum requirements include a high school diploma and at least 4 years in grievances/appeals, along with strong communication skills