at Manpower Group in Meridian, Idaho, United States Job Description Our client, a leading healthcare organization, is seeking a Grievance & Appeals Specialist I to join their team. As a Grievance & Appeals Specialist I, you will be part of the healthcare operations department supporting member and provider relations. The ideal candidate will have strong analytical skills, excellent communication abilities, and a detail-oriented mindset, which will align successfully in the organization.

Job Title:

Grievance & Appeals Specialist Location:

Meridian, ID Pay Range:

$27 an hour

Shift:

Monday-Friday | 8:00 AM-5:00 PM What's the Job? + Investigate, analyze, and manage member appeals and grievance cases to ensure timely resolution. + Ensure cases are accurately classified, categorized, and documented in compliance with regulatory standards. + Research complex issues and determine if additional information is needed to support decision-making processes. + Prepare detailed case histories for committee reviews, audits, and regulatory compliance purposes. + Interpret and apply business rules, policies, benefit plans, and contract language effectively. What's Needed? + Minimum of 3 years of experience in healthcare operations, claims, appeals, or customer service. + Strong verbal and written communication skills to effectively interact with members and providers. + Knowledge of medical terminology, ICD -10, and CPT coding systems. + Experience interpreting individual and group contract language. + Strong analytical, investigative, and problem-solving skills to handle complex cases. + Claims processing experience preferred. What's in it for me? + Opportunity to work in a dynamic healthcare environment committed to making a positive impact. + Engage in meaningful work that supports member and provider satisfaction. + Collaborate with a dedicated team of professionals in a supportive setting. + Gain valuable experience in healthcare compliance and regulatory standards. + Be part of an organization that values diversity and inclusion. Upon completion of waiting period, associates are eligible for: + Medical and Prescription Drug Plans + Dental Plan + Supplemental Life Insurance + Short Term Disability Insurance + 401(k) If this is a role that interests you and you'd like to learn more, click apply now and a recruiter will be in touch with you to discuss this great opportunity. We look forward to speaking with you! •

About ManpowerGroup, Parent Company of:

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