Job Description
Job Description
Engagement Description
Responsible for processing appeals and grievances by analyzing, researching, and providing comprehensive responses in accordance with established regulatory and accreditation guidelines. Contacts customers to gather necessary information and communicates the disposition of cases. Conducts research to evaluate, respond to, and finalize each case. Familiar with standard concepts, practices, and procedures for analyzing and interpreting data, as well as applying contract and regulatory provisions.
Required Skills and Experience
- Candidates must have a High School Diploma or GED and a minimum of two (2) years of customer service experience.
- They should be able to manage a large workload in a fast-paced environment and possess strong computer skills.
- The role requires the ability to write letters, think analytically, conduct research, and multitask effectively.
Preferred Skills and Experience
- A Bachelor’s Degree in English, Communications, Healthcare, or a related field is preferred.
- Candidates with at least two (2) years of health insurance experience and familiarity with state and federal regulations are highly desirable.
- Strong project management skills are also preferred.
- Additional preferred qualifications include experience with grievances and appeals, analyzing claims, and classifying cases between grievance, appeal, and organizational determination.
- Proficiency in letter writing and basic computer skills—such as saving PDFs, navigating Excel, and learning new systems—is also beneficial.
Company DescriptionFounded in 1998 and headquartered in Farmington Hills, MI, Kyyba has a global presence delivering high-quality resources and top-notch recruiting services, enabling businesses to effectively respond to organizational changes and technological advances.
At Kyyba, the overall well-being of our employees and their families is important to us. We are proud of our work culture which embodies our core values; incorporating value, passion, excellence, empowerment, and happiness, creates a vibrant and productive atmosphere. We empower our employees with the resources, incentives, and flexibility that they need to support a healthy, balanced, and fulfilling career by providing many valuable benefits and a balanced compensation structure combined with career development.
Kyyba is an Equal Opportunity Employer.
Kyyba does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other b
Company Description
Founded in 1998 and headquartered in Farmington Hills, MI, Kyyba has a global presence delivering high-quality resources and top-notch recruiting services, enabling businesses to effectively respond to organizational changes and technological advances.\r\n\r\nAt Kyyba, the overall well-being of our employees and their families is important to us. We are proud of our work culture which embodies our core values; incorporating value, passion, excellence, empowerment, and happiness, creates a vibrant and productive atmosphere. We empower our employees with the resources, incentives, and flexibility that they need to support a healthy, balanced, and fulfilling career by providing many valuable benefits and a balanced compensation structure combined with career development.\r\n\r\nKyyba is an Equal Opportunity Employer.\r\n\r\nKyyba does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other b