Appeals & Grievance Analyst
Minneapolis, MN, US
Bright Health is delivering a smarter, more connected healthcare experience. Our affordable health insurance plans and exclusive partnerships with leading health systems are reshaping how people and physicians achieve better health. Today, Bright Health provides health insurance to individuals in Colorado, Arizona, and Alabama in both the Individual and Medicare Advantage space.
Come join our mission: Making Healthcare Right. Together!
The Appeal & Grievance Analyst is responsible for the management and coordination of assigned member appeals and grievances received at Bright Health Plan. To do this, you will act as a liaison between Bright Health and the enrolee; clearly communicating the appeal and grievance process and procedures both verbally and in writing. You will recommend approval, denial, or resolution steps for requests based on the enrollee’s contract, available benefits, and individual circumstances presented. Most importantly, you must demonstrate superior customer service skills in all interactions.
You have 3 years of experience in a health plan operations (ie. Appeals & Grievance setting, or Customer Service setting)
You understand the regulatory and compliance rules surrounding appeals and grievances
Analytical skills to be able to monitor trends and/or gaps in services to improve enrolee experience and address operational changes
Experience in process documentation, workflows, and best practices
You are a self-starter that is deeply motivated to join an organization that places relationships at the center of better healthcare delivery
You enjoy designing processes to solve problems, collaborating with other members of a team, and strong documentation skills
You are results and detail oriented, and are always seeking to understand the big picture
We've won some fun awards like: Great Places to Work, Modern Healthcare, Forbes, etc. But more than anything, we're a group of people who are really dedicated to our mission in healthcare. Come join our growing team!