Appeals and Grievances Representative, Advanced - CalPERS
California Physicians' Service•El Dorado Hills, CA
388d
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About The Position
The Appeals and Grievances Representative is responsible for managing and resolving member appeals and grievances in a timely manner. This role involves answering inquiries, investigating issues, and providing explanations of health plan benefits to members and providers. Strong communication skills and the ability to work both independently and collaboratively are essential to meet compliance standards.
