Healthcare Appeals & Grievance Specialist (Hybrid)

A healthcare organization in Troy, MI, seeks an Appeals & Grievance Analyst to handle medical and pharmacy member appeals. You will investigate and resolve grievances, ensuring adherence to CMS guidelines while communicating effectively with members and stakeholders. Ideal candidates will have a minimum of 3 years in customer service and 2 years of claim review experience. Strong analytical skills and knowledge of Medicare Advantage are essential. This hybrid role supports regulatory compliance and case presentations. #J-18808-Ljbffr