Grievances & Appeals Risk Analyst I

2 weeks ago

Norfolk, United States Elevance Health Full time

Job Family: CLM > Claims Support

Type: Full time

Date Posted: May 20, 2024

Anticipated End Date: Jun 10, 2024

Reference: JR116616

Description

**Title: Grievances & Appeals Risk Analyst I**

The **Grievances & Appeals Risk Analyst I **will be responsible for responding to inquiries received from regulatory agencies for one or more states or functions and/or for responding to inquiries/complaints received by executive leadership. Responsible for providing support to legal, management and executive level associates through a variety of assignments and projects which utilize knowledge specific to the company.

**How you will make an impact**:

- Analyzes and evaluates inquiries, complaints, reports, and/or filings.
- Prepares and organizes case research, notes, and documents.
- Conducts research and analysis, and recommends appropriate course of action and next steps for management review.
- Performs fact checking, gathers documents, researches and responds to inquiries and records requests and assists with investigative and discovery activities and processes.
- Corresponds with attorneys both internal and external in grievances and appeals regulatory cases.

**Minimum Requirements**
- HS diploma
- Minimum of 2 years of G&A or related experience; or any combination of education and experience which would provide an equivalent background.

**Preferred Qualifications**
- BA/BS in a related field preferred.
- Paralegal certification and experience preferred.

For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

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