- End-to-End Appeal Processing: Review, research, and process healthcare appeals and grievances from initiation through final resolution.
- US Healthcare Compliance: Ensure all appeals and grievances are handled in compliance with US healthcare guidelines, client policies, and turnaround time (TAT) standards.
- Case Documentation: Accurately document case findings, clinical/administrative rationales, and resolution outcomes in the system.
- Quality & Productivity: Maintain high accuracy and quality benchmarks across all processed non-voice transactions.
- Domain Experience: Hands-on experience in Appeals and Grievances handling within US Healthcare is mandatory. (Note: Only international experience is required /considered).