- Overview
- To review, process, and resolve member and provider appeals in a timely and accurate manner,ensuring compliance with regulatory turnaround times This role is critical in maintaining servicequality and upholding member rights within a high-pressure, time-sensitive environment.

- Primary Responsibilities
- Accurately review and process appeals and grievances submitted by members or providers.

- Ensure all cases are resolved within regulatory and internal turnaround times, especially expeditedappeals.

- Communicate effectively with internal departments, providers, and members to gather necessary documentation and clarify case details.

- Maintain detailed and accurate documentation of all case activities in the system.

- Identify and escalate complex or sensitive cases to appropriate stakeholders.

- Always adhere to HIPAA and privacy regulations.

- Participate in quality audits and continuous improvement initiatives.

- Support peers and leadership in maintaining 24/7 operational coverage, including flexible week-offsand rotational shifts.

- Must Have Skills
- Attention to the details to process

- Communication Skills.

- Valuable Typing Speed with quality

📌 Non Voice Process Executive (Hyderabad)
🏢 Joulestowatts
📍 Hyderabad