FAQs
What is the primary responsibility of the Grievance & Appeals Risk Analyst I?
The primary responsibility of the Grievance & Appeals Risk Analyst I is to respond to inquiries received from regulatory agencies or executive leadership, providing support through research, documentation, analysis, and recommendations related to grievances and appeals.
Where is this position located, and what is the work model?
This position is located in the United States and operates on a hybrid model, which includes both remote work and office attendance. Ideal candidates should live within 50 miles of a PulsePoint location.
What minimum qualifications are required for this position?
The minimum qualifications required include a high school diploma and at least 2 years of experience in grievances and appeals or a related field, or a combination of education and experience that provides an equivalent background.
Are there any preferred qualifications for this role?
Yes, preferred qualifications include a BA/BS in a related field, paralegal certification and experience, claims adjustment experience, and proficiency in business writing. Familiarity with provider networks, the medical management process, claims processes, and internal business processes is also preferred.
What skills are important for success in this role?
Important skills for success in this role include strong oral, written, and interpersonal communication skills, problem-solving abilities, facilitation skills, and analytical skills.
What is the salary range for this position?
The salary range for this specific position is $27.95/hr. to $41.93/hr., depending on various legitimate factors, including geographic location, work experience, education, and skill level.
Does Elevance Health offer any additional benefits aside from salary?
Yes, Elevance Health offers a comprehensive benefits package that includes incentive and recognition programs, equity stock purchase options, and 401k contributions, all subject to eligibility requirements.
What is the importance of WGS experience for this position?
WGS experience is strongly preferred as it demonstrates familiarity with the specific processes and systems that may be utilized within the grievances and appeals framework, enhancing the analyst's effectiveness in responding to inquiries and complaints.
What is the nature of the communication that the Grievance & Appeals Risk Analyst I will handle?
The analyst will correspond with both internal and external attorneys regarding grievances and appeals regulatory cases, requiring proficiency in professional communication and documentation management.
Will the salary be the same for all candidates applying for this position?
No, the actual compensation may vary based on factors such as geographic location, work experience, education, and skill level, even within the stated salary range. Additionally, the company reserves the right to modify compensation based on market and business considerations.