Appeals Specialist
3 weeks ago
We are seeking a highly skilled Appeals Specialist to join our team at HR Studio Ltd. As an Appeals Specialist, you will play a critical role in analyzing and resolving verbal and written claims and authorization appeals.
Key Responsibilities:- Analyze and resolve appeal issues and relevant claims using guidelines and tools.
- Collect, analyze, and report verbal and written complaints and appeals from members and providers.
- Draft response letters for member and provider appeals.
- Maintain detailed records of all complaints, resolutions, and documentation for tracking and auditing purposes.
- Act as a liaison between members, providers, regulatory agencies, and internal teams.
- Matric Diploma or equivalent; associates degree preferred.
- 2 years grievance and appeals, claims or related healthcare experience, preferably in a carrier or TPA setting.
- Familiarity with CMS standards and requirements related to complaint resolution.
- Proficient in Microsoft Office.
- Maintain confidentiality and exercise discretion in handling sensitive information.
- 3-6 weeks of training.
- Opportunity to work with a dynamic team.
- Competitive salary and benefits package.
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Appeals Specialist
4 weeks ago
Sandton, South Africa HR Studio Ltd Full timeJob Title: Claims Appeals Call Centre AgentWe are seeking a highly skilled and detail-oriented Appeals Specialist to join our team at HR Studio Ltd.Job Summary:The successful candidate will be responsible for analyzing and resolving verbal and written claims and authorization appeals through coordination with providers and members. This role requires...
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Appeals Specialist
4 days ago
Sandton, South Africa HR Studio Full timeWe're seeking a skilled Appeals Specialist to join our team at HR Studio.This role involves analyzing and resolving verbal and written claims and authorization appeals through coordination with providers and members.You will be responsible for:Utilizing guidelines and tools to conduct research and analyze appeal issues and relevant claims.Collecting,...
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Appeals Specialist
2 days ago
Sandton, South Africa HR Studio Ltd Full timeWe are seeking a highly skilled Appeals Specialist to join our team at HR Studio Ltd. This role is responsible for analyzing and resolving verbal and written claims and authorization appeals through coordination with providers and members.The ideal candidate will have the ability to communicate clearly and professionally with internal and external customers,...
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Claims Appeals Specialist
2 months ago
Sandton, South Africa HR Studio Full timePosition Overview: We are seeking a dedicated Appeals Specialist who will be responsible for evaluating and resolving both verbal and written claims and authorization appeals. This role involves close collaboration with healthcare providers and members to ensure timely and accurate responses while maintaining meticulous records of all appeals. Key...
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Claims Appeals Specialist
2 months ago
Sandton, South Africa HR Studio Full timePosition Overview: We are seeking a dedicated Appeals Specialist who will be responsible for the thorough analysis and resolution of both verbal and written claims and authorization appeals. This role involves effective coordination with healthcare providers and members, ensuring timely preparation of responses while maintaining exemplary record-keeping...
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Claims Appeals Resolution Specialist
1 month ago
Sandton, South Africa HR Studio Full timeJob Title: Claims Appeals Call Centre AgentWe're seeking a skilled Appeals Specialist to join our team at HR Studio. As a key member of our team, you will play a crucial role in analyzing and resolving verbal and written claims and authorization appeals.Key Responsibilities:Analyze and resolve appeal issues using available resources and sound...
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Claims Appeals Specialist
3 weeks ago
Sandton, South Africa HR Studio Full timeJob Title: Claims Appeals Call Centre AgentWe're seeking a skilled Appeals Resolution Expert to join our team at HR Studio.About the Role:As an Appeals Resolution Expert, you will be responsible for analyzing and resolving verbal and written claims and authorization appeals through coordination with providers and members.You will prepare responses within...
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Claims Appeals Specialist
1 week ago
Sandton, South Africa HR Studio Full timeJob Title: Claims Appeals Call Centre AgentWe're seeking a highly skilled and detail-oriented Claims Appeals Call Centre Agent to join our team at HR Studio.About the Role:This is a challenging and rewarding role that requires strong analytical and communication skills. As a Claims Appeals Call Centre Agent, you will be responsible for analyzing and...
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Claims Appeals Call Centre Agent
2 weeks ago
Sandton, South Africa HR Studio (Pty) Ltd Full timeWe’re looking for… An Appeals Specialist that will analyze and resolve verbal and written claims and authorization appeals through coordination with providers and members. You will be preparing responses within required timeframes and track the status of all appeals with exemplary record-keeping. Who are you? - You have the ability to communicate...
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Claims Appeals Call Centre Agent
3 months ago
Sandton, South Africa HR Studio Full timeWe're looking for… An Appeals Specialist that will analyze and resolve verbal and written claims and authorization appeals through coordination with providers and members. You will be preparing responses within required timeframes and track the status of all appeals with exemplary record-keeping. Who are you? You have the...
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Claims Resolution Specialist
2 months ago
Sandton, South Africa HR Studio Full timePosition Overview: We are seeking a dedicated Appeals Specialist who will be responsible for evaluating and addressing both verbal and written claims and authorization appeals. This role involves collaborating with healthcare providers and members to ensure timely and accurate responses while maintaining meticulous records of all appeals. Key...
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Social Media Specialist
5 months ago
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Specialist Production Analyst
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Junior UI Design Specialist
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Business Intelligence Specialist
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Application Developer
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Digital Marketing Specialist
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Digital, Marketing and Social Media Specialist
5 months ago
Sandton, South Africa C & G (Hospitality) Recruitment Full timeA luxury Hotel Group in Sandton is requiring a Marketing, Online and Social Media Specialist. You will be responsible for representing the client through their online presence by implementing and managing the Company’s Social Media strategy in order to increase the online presence and improve our marketing and sales efforts. - Implement and manage the...
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Digital Marketing Specialist
3 weeks ago
Sandton, South Africa Catch Recruit Full timeJob Title: Digital Marketing DeveloperOur client's Digital Marketing Team is seeking a skilled professional to collaborate with their team and contribute to the development of innovative digital marketing solutions.Key Responsibilities:Develop and maintain visually appealing and responsive websites, landing pages, and online marketing campaigns.Collaborate...