Member Appeals & Grievance Analyst-2

We are hiring a Member Appeals & Grievance Analyst at BCBST! In this role, you will review and process appeals and grievances submitted by members and providers, ensuring timely and accurate resolution in compliance with CMS and Medicare guidelines. You will evaluate cases, determine appropriate next steps, and manage multiple priorities while meeting required turnaround times. You’ll play a critical role in maintaining regulatory compliance, improving member experience, and supporting high-quality outcomes through detailed case analysis and effective use of digital tools to drive efficiency. To be successful in this role, in addition to the core job requirements, you'll bring strong analytical skills, attention to detail, and a customer-focused approach.…