Healthcare Analyst

3 weeks ago


Norfolk, Virginia, United States Elevance Health Full time

Job Summary:

Elevance Health is seeking a skilled Grievance and Appeals Analyst to join our team. As a key member of our Enterprise Grievance & Appeals Department, you will play a critical role in reviewing, analyzing, and processing non-complex grievances and appeals requests from various customer types and products.

Key Responsibilities:

  • Review and analyze non-complex grievances and appeals in accordance with external accreditation and regulatory requirements, internal policies, and claims events.
  • Utilize guidelines and review tools to conduct extensive research and analyze the grievance and appeal issue(s) and pertinent claims and medical records.
  • Analyze and render determinations on assigned non-complex grievance and appeal issues and complete the respective written communication documents.
  • Collaborate with internal departments, including grievances & appeals, medical management, legal, and service operations.

Requirements:

  • Minimum of 3 years of experience working in grievances and appeals, claims, or customer service.
  • Demonstrated business writing proficiency and understanding of provider networks, the medical management process, claims process, and internal business processes.

About Elevance Health:

Elevance Health is a health company dedicated to improving lives and communities. 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.

What We Offer:

  • Market-competitive total rewards, including merit increases, paid holidays, Paid Time Off, and incentive bonus programs.
  • Medical, dental, vision, short and long-term disability benefits, 401(k) + match, stock purchase plan, life insurance, wellness programs, and financial education resources.

Equal Employment Opportunity:

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status, or any other status or condition protected by applicable federal, state, or local laws.


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