Find & Apply For Customer Service Representative Jobs in Huntingtn Bch, California

Jobot is seeking an Appeals Specialist to support our Professional, Scientific & Technical Services clients by managing end-to-end appeals workflows. You will review documentation, research policies, analyze determinations, and prepare clear, well-supported appeal submissions. Partnering closely with recruiters, hiring teams, and external stakeholders, you will track cases, report trends, and recommend process improvements. This role is ideal for detail-oriented professionals who enjoy research, documentation, and problem-solving in a collaborative, tech-enabled environment. Responsibilities Review and analyze appeal requests, supporting documentation, and determinations for accuracy and completeness. Research relevant policies, guidelines, and regulations to support appeal strategies and recommendations. Draft clear, well-structured appeal letters and supporting summaries tailored to client and stakeholder requirements. Maintain accurate records in case-management or CRM tools, ensuring timelines, statuses, and outcomes are tracked. Collaborate with recruiters, account managers, and client contacts to gather information and resolve complex cases. Identify patterns and trends in appeal outcomes and provide feedback for process and quality improvements. Prepare reports and metrics on appeal volumes, turnaround times, and results for internal and client stakeholders. Support audits, quality checks, and compliance activities related to appeals documentation and workflows. Required Skills Claims review and analysis Appeals drafting and documentation Regulatory and policy interpretation Data entry and records management Case tracking and workflow tools (CRM or case-management software) MS Office or Google Workspace proficiency Quality assurance and audit support Client communication and reporting Process improvement and trend analysis Time management and prioritization