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Appeals and Grievance Specialist

Macpower Digital Assets Edge Private Limited | Irving, Texas, United States | Posted May 14, 2026

Position Overview


Job Summary:


  • This position requires the ability to work independently researching and reviewing inquiries from members and providers that also requires knowledge of benefit interpretation, claims reviews, CPT and ICD coding.

  • Bachelor's Degree and minimum 5 years of relevant experience.



Requirements:


  • Research and provide resolution to issues such as claim denials, member and provider complaints, and reconsideration and redetermination requests.

  • Review and respond to complaints, grievances and appeals within the stated time frame for each request

  • Certify that providers and members are reimbursed accordingly using Medicare reimbursement policies and procedures Requirements.



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