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Elevance Health · 1 day ago

Grievance/Appeals Analyst I (Indianapolis, IN)

Indianapolis, IN

Full-time

Hybrid

Entry Level

3+ years exp

Elevance Health is a health company dedicated to improving lives and communities. They are seeking a Grievance/Appeals Analyst I to review, analyze, and process non-complex grievances and appeals requests from various customer types, ensuring compliance with accreditation and regulatory requirements.

Health CareHealth InsurancePersonal HealthWellness

H1B Sponsor Likely

Responsibilities

Reviews, analyzes and processes non-complex grievances and appeals in accordance with external accreditation and regulatory requirements, internal policies and claims events requiring adaptation of written response in clear, understandable language

Utilizes guidelines and review tools to conduct extensive research and analyze the grievance and appeal issue(s) and pertinent claims and medical records to either approve or summarize and route to nursing and/or medical staff for review

The grievance and appeal work is subject to applicable accreditation and regulatory standards and requirements

As such, the analyst will strictly follow department guidelines and tools to conduct their reviews

The file review components of the URAC and NCQA accreditations are must pass items to achieve the accreditation

Analyzes and renders determinations on assigned non-complex grievance and appeal issues and completion of the respective written communication documents to convey the determination

Responsibilities exclude conducting any utilization or medical management review activities which require the interpretation of clinical information

The analyst may serve as a liaison between grievances & appeals and /or medical management, legal, and/or service operations and other internal departments

Qualification

GrievancesAppealsBusiness writing proficiencyClaims processProvider networksMedical management process

Required

HS diploma or GED

Minimum of 3 years experience working in grievances and appeals, claims, or customer service; or any combination of education and experience which would provide an equivalent background

Preferred

Demonstrated business writing proficiency, understanding of provider networks, the medical management process, claims process, the company's internal business processes, and internal local technology is highly preferred

Benefits

Merit increases

Paid holidays

Paid Time Off

Incentive bonus programs

Medical

Dental

Vision

Short and long term disability benefits

401(k) +match

Stock purchase plan

Life insurance

Wellness programs

Financial education resources

Company

Elevance Health

Glassdoor3.6

Elevance Health is an integrated whole-health approach to help people in health journey and address their full range of needs.

Founded in 1944

Indianapolis, Indiana, USA

10001+ employees

https://www.elevancehealth.com

H1B Sponsorship

Elevance Health has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

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Trends of Total Sponsorships

2025 (488)

2024 (604)

2023 (660)

2022 (222)