Complaint & Appeals Consultant - (Dublin, OH)

POSITION OVERVIEW The Complaint and Appeals Consultant is the subject matter expert and independently coaches others on complaints and appeals ensuring compliance with Federal and/or State regulations They manage control and trend inventory, independently investigate, change or revise policy to resolve the most escalated cases coming from broad, internal and external constituents for all products and issues. Independently manage all department of insurance and executive complaints, and solely responsible for handling and responding to all media relations. Responsible for compliance with policies of all applicable Federal and/or State government agencies, including but not limited to Center for Medicaid and Medicare (CMS), Department of Public Welfare, Department of Health, and Department of Insurance. Fundamental Components & Physical demands include but are not limited to: Responsibilities will have national scope. Familiarity with national regulations and legislation.