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Appeals and Complaints Specialist

Company: VirtualVocations
Location: Largo
Posted on: April 6, 2025

Job Description:

A company is looking for an Appeal & Complaints Specialist who will handle complaints and appeals related to dental and vision services.
Key Responsibilities

Review, analyze, and process complaints and appeals from members, providers, and health plans
Communicate with internal staff and external entities to resolve payment disputes and quality of care issues
Document all appeal and complaint activities accurately for reporting and compliance purposes

Required Qualifications, Training, and Education

High school diploma or equivalent required
At least 1 year of job-related experience in a healthcare setting
1 year of experience interacting with customers and clients
Knowledge of general computer software, including Outlook, Excel, and MS Word
Ability to work overtime as needed

Keywords: VirtualVocations, Orlando , Appeals and Complaints Specialist, Other , Largo, Florida

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