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About the Role:
- Own the end-to-end handling of member and provider appeals and grievances, investigating cases and delivering resolutions within regulatory timelines.
- Work at the intersection of advocacy, compliance, and operations, reporting to the Director of Quality and Continuous Improvement.
What You'll Do:
- Intake, triage, and manage a caseload of appeals and grievances from submission through resolution.
- Investigate each case thoroughly, reviewing claims history, clinical documentation, and prior correspondence.
- Draft clear, compliant resolution letters and track all deadlines for regulatory compliance.
What You'll Bring:
- Bachelor's degree and 3+ years of experience in appeals and grievances or health insurance operations.
- Strong analytical skills and excellent written communication to explain complex determinations in plain language.
- A member-first mindset balanced with rigorous attention to policy and compliance.
Sidecar Health
Sidecar Health is redefining health insurance by making healthcare affordable and accessible. The team is composed of passionate individuals from diverse backgrounds including tech, policy, and healthcare, all united by a mission to fix a broken system.