Anthem Remote Jobs Work from Home Apply Now 2022 Limited Vacancy

By | April 13, 2022

Job Responsibilities : Grievance/Appeals Representative II – Behavioral Health

Salary : $17 per hour

Company : Anthem

Location : Remote US


  • Conducts investigation and review of customer grievances and appeals involving provision of service and benefit coverage issues.
  • Contacts customers to gather information and communicate disposition of case; documents interactions.
  • Generates written correspondence to customers such as members providers and regulatory agencies.
  • Researches administrative or non-clinical aspects of the appeal e.g. eligibility benefit levels overall adherence to policies and practices.
  • May make decision on administrative appeals where guidelines are well documented and involve limited discretion.
  • Prepares files for internal or external review by analysts medical staff or outside consultant.
  • Triages clinical and non-clinical inquiries grievances and appeals prepares case files for member grievance committees/hearings.
  • Summarizes and presents essential information for the clinical specialist or medical director and legal counsel.


  • Requires a HS diploma or equivalent
  • Minimum of 2 years experience in customer service preferably in a managed care environment medical office or health insurance; or any combination of education and experience which would provide an equivalent background.
  • Ability to organize work set and manage multiple priorities in a time sensitive manner is strongly preferred.
  • Good oral and written communication skills basic word processing data base management spreadsheet skills PC proficiency and claims knowledge strongly preferred.

Preferred Qualifications/Skills/Experience:

  • Behavioral health
  • Managed care
  • MS Office

Click Here : Apply Now