Temporary Case Specialist (Remote/Hybrid) – Appeals

Blue Cross & Blue Shield of Rhode Island; United States; Hybrid; USD 60,000 - 90,000; Full time

Benefits offered by this job

Flexible work arrangements (remote/hy‑

Paid time off

Tuition reimbursement

Student-loan repayment assistance

Health/dental/vision insurance

Mental health programs

Bonuses and investment plans

Volunteer time off

Job summary

BCBSRI in Providence, RI seeks a detail-oriented professional to investigate and resolve member and provider complaints, benefits and administrative appeals. You will maintain appeal records and ensure compliance with regulatory requirements.

Responsibilities include responding to inquiries, educating members about plan details, analyzing trends with internal teams, and supporting department audits and projects. A high school degree and 2–4 years in managed care are required.

Qualifications

• Written and verbal communications skills required.
• Knowledge of health insurance laws and regulations.
• Working knowledge of Microsoft Office including Excel and Word.
• General computer proficiency required.
• Good organization and time management skills.

Responsibilities

• Investigate and resolve member and provider complaints, benefits appeals, and administrative appeals for all company products.
• Maintain documentation of cases.
• Respond to inquiries and assist with special member cases and resolutions.
• Educate members to understand the plan.

Skills

Written and verbal communications

Microsoft Excel

Microsoft Word

General computer proficiency

Time management

Detail oriented

Organizational skills

Research data organization

Education

High school degree

Tools

Microsoft Office

Job description

BCBSRI in Providence, RI seeks a detail-oriented professional to investigate and resolve member and provider complaints, benefits and administrative appeals. You will maintain appeal records and ensure compliance with regulatory requirements.

Responsibilities include responding to inquiries, educating members about plan details, analyzing trends with internal teams, and supporting department audits and projects. A high school degree and 2–4 years in managed care are required.