Appeals Analyst - Missouri

Key responsibilities: Gather and review information to determine resolutions for complaints, grievances, and appeals Document work according to department Standard Operating Procedures to ensure clarity and consistency Develop timely and accurate responses to complaints and ensure compliance with relevant regulations and procedures

Required qualifications: Bachelor's degree in business, finance, accounting, law, health care administration, or relevant experience in the health insurance industry 1-3 years of experience in a health insurer role related to customer claim or benefit issues Ability to communicate effectively with members, providers, and internal teams Working knowledge of member health benefit certificates and BCBSKC medical policies Familiarity with federal, state, and accreditation requirements related to complaints and appeals