Appeals Specialist I (Remote)

**Resp & Qualifications**

**PURPOSE:**
The Appeals Specialist I is responsible for the initial analysis of appeals and/or grievance correspondence, and determination of next steps for the following line of business: Commercial. The incumbent is responsible for collecting, organizing and tracking information to facilitate and expedite processing of appeals and/or grievances received from a variety of sources. We are looking for an experienced professional to work remotely from within the greater Baltimore metropolitan area. The incumbent will be expected to come into a CareFirst location periodically for meetings, training and/or other business-related activities. The ideal candidate will have previous experience working with appeals and grievances in a healthcare payor organization.

**ESSENTIAL FUNCTIONS:**

+ Prioritize, research and analyze all pertinent information of an appeal and/or grievance request. Access the appropriate technology platform to imp...