Lead Ii Bpm (Appeals & Grievance Analyst)
• Dedicated professional with expertise in researching and analyzing grievances and appeals for Medicare Advantage HMO and PPO products, demonstrating strong written and oral communication with members and providers. • Proficient in inventory management and actively involved in developing and implementing strategies to reduce appeals and grievances. • Collaborates with cross-functional teams to resolve issues efficiently, gathering and analyzing data for process improvement.