Independence Blue Cross LLC
Manager Appeals (Legal)
Bring your drive for excellence, teamwork, and customer commitment to Independence. Join us as we renew and reimagine the future of health care. Together we will achieve our mission to enhance the health and well-being of the people and communities we serve.
At Independence, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.
The Manager Medicare Appeals and Grievances manages member appeal processes to include intake/triage functions, investigations, resolutions, documentation, determinations, and follow-up activities for Medicare member appeals, grievances, and Quality Insight Organization (QIO) for core and ASO business according to regulatory and accreditation standards, contractual arrangements, and benefit plans. Trends appeal issues, implements revised department procedures, and recommends corporate policy and procedure changes to reduce the volume of appeals and improve member satisfaction. Ensures timely, accurate and compliant appeals processing for member and provider satisfaction, efficient corporate processes, and to avoid regulatory or accreditation penalties.
Hybrid of Choice:
Independence has implemented a “Hybrid of Choice” model which provides our associates with the flexibility to choose whether to work remotely, work in the office every day, or work in the office on certain days at their discretion. However, management may require our associates to work from Independence's physical office locations on certain occasions. This role is designated as a role that fits into the “Hybrid of Choice” model. While associates may work remotely, the work must be performed in the Tri-State Area of Delaware, New Jersey or Pennsylvania.