Grievances & Appeals Representative
Humana•Salt Lake City, UT
461d•$43,400 - $59,600•Remote
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About The Position
The Grievances & Appeals Representative 4 plays a crucial role in managing client denials and concerns by conducting thorough analytic reviews of clinical documentation. This position is responsible for determining the necessity of grievances, appeals, or further requests, and delivering final determinations based on specialized skills and collaboration with clinical teams. The representative leads advanced administrative and operational support duties, requiring independent initiative and judgment, while also assisting members and supporting quality-related goals.
