Medicaid Appeals Specialist
Company: VirtualVocations
Location: Vista
Posted on: May 24, 2025
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Job Description:
A company is looking for a Specialist, Appeals & Grievances with
Medicaid experience.
Key Responsibilities
Review and resolve member and provider complaints in accordance
with Medicaid standards
Conduct comprehensive research on appeals, grievances, and
complaints to ensure compliance with timelines
Prepare appeal summaries and correspondence, ensuring accuracy and
adherence to regulatory requirements
Required Qualifications
High School Diploma or equivalency
Minimum 2 years of operational managed care experience
Health claims processing background, including coordination of
benefits and eligibility criteria
Familiarity with Medicaid claims denials and appeals processing
Keywords: VirtualVocations, La Puente , Medicaid Appeals Specialist, Other , Vista, California
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