Appeals & Grievances (A&G) Advocate - Medicare Advantage Health Plans

Job Title

Appeals & Grievances (A&G) Advocate – Medicare Advantage (US Healthcare)

Location

India/Philippines (Onsite)

Reporting To

A&G Lead / Manager – Operations

Role Overview

The Appeals & Grievances (A&G) Advocate is responsible for managing member and provider appeals and grievances Medicare advantage health plan members. The role requires strong CMS regulatory knowledge, high empathy for vulnerable populations, and the ability to provide clear, professional phone support along with compliant written determinations.

This is a high-accuracy, compliance-critical role supporting Medicare Advantage programs.

Key Responsibilities

Medicare advantage health plan Appeals & Grievances Processing

• Handle member and provider app...