Appeals Coordinator

Hornet Staffing, Inc, a GEE Group company

Date: 2 days ago
City: Irving, TX
Salary: $30.00 - $32.00 / hr
Contract type: Full time

Hiring: Appeals & Grievance Specialist II

Location: Irving, TX (Onsite)

Pay Rate: $31-$32/hr

Are you an experienced healthcare professional with a background in Managed Care, Appeals & Grievances, and Claims Review? We are seeking a detail-oriented Appeals & Grievance Specialist II to join a leading health plan and support member and provider issue resolution.

Research and resolve member and provider complaints, appeals, and grievances

Review claim denials, reconsiderations, and redetermination requests

Interpret benefits and analyze claims information

Ensure compliance with state and federal healthcare regulations

Collaborate with cross-functional teams for timely issue resolution

Track, trend, and report appeal and grievance data

Identify root causes and recommend process improvements

3+ years of Appeals & Grievance experience within a Managed Care Plan

Strong customer service and communication skills

Experience with claims review and benefit interpretation

Knowledge of CPT and ICD coding

Excellent analytical and problem-solving abilities

Interested candidates can send their updated resume to [] or connect with me directly on LinkedIn.

#Hiring #AppealsAndGrievances #ManagedCare #HealthcareJobs #ClaimsReview #HealthPlan #IrvingTX #HealthcareCareers #OpenToWork #Recruitment

For employers only

Is this your company's job post? Verify ownership to manage this listing and receive applications directly.

Claim this listing

Looking to apply for this job? Use the Apply button above.

See more jobs in Irving, TX