A&G Dismissal Specialist

Job Summary

A company is looking for an A&G Dismissal Specialist responsible for non-clinical case development and resolution.

Key Responsibilities

• Manage case development and resolution for non-clinical cases, including claim denials and member complaints
• Investigate and resolve member representative cases while ensuring compliance with regulations
• Handle Department of Health and executive complaints as needed

Required Qualifications

• Proven work experience in appeals and grievances or a healthcare environment
• High School Diploma or GED from an accredited institution
• Ability to work flexible hours, including weekends and evenings
• Experience in handling complex situations and projects
• Proficient in Microsoft Office Suite applications, particularly Excel