Grievance/Appeals Analyst

Welcome to Elevance Health, where we are committed to providing exceptional healthcare services and support to our members. We are currently seeking a highly skilled and dedicated Grievance/Appeals Analyst to join our team. As a Grievance/Appeals Analyst, you will play a critical role in ensuring that our members' concerns and appeals are handled with the utmost care and attention. We are looking for an individual who is passionate about advocating for our members' rights and has a strong background in healthcare and customer service. If you are a detail-oriented individual with excellent communication skills and a commitment to providing exceptional service, we would love to have you join our team at Elevance Health.

• Review and process member grievances and appeals in a timely and accurate manner.
• Act as the primary point of contact for members regarding their concerns and appeals, providing compassionate and knowledgeable support.
• Conduct thorough investigations into member grievances and appeals, gathering all necessary information and documentation.
• Collaborate with other departments and external entities to gather information and ensure timely resolution of member concerns.
• Maintain detailed and accurate records of all grievances and appeals, including status updates and outcomes.
• Analyze trends and patterns in member grievances and appeals to identify opportunities for process improvement.
• Advocate for members' rights and ensure that their concerns are addressed and resolved in a fair and appropriate manner.
• Maintain a strong understanding of relevant laws, regulations, and policies related to healthcare and member rights.
• Support and participate in training and development opportunities for team members to ensure consistent and high-quality service.
• Communicate effectively with team members and management to provide updates on member concerns and appeals.

According to JobzMall, the average salary range for a Grievance/Appeals Analyst in Boston, MA, USA is $55,000 - $75,000 per year. This may vary based on factors such as experience, education, and the specific company or industry the individual is employed in.

Elevance Health, Inc. is an American health insurance provider. The company's services include medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans through affiliated companies such as Anthem Blue Cross and Blue Shield, Empire BlueCross BlueShield in New York State, Anthem Blue Cross in California,Wellpoint, and Carelon.It is the largest for-profit managed health care company in the Blue Cross Blue Shield Association. As of 2022, the company had 46.8 million members within their affiliated companies' health plans. Prior to June 2022, Elevance Health was named Anthem, Inc.