Grievance and Appeals position with a large insurance provider. M-F, fully remote, must live in Sacramento Area.

Description:

• Assist with telephone inquiries regarding member appeals
• Respond to appeals and grievances and member reconsiderations specific to mandates
• Research, review and resolve high level/high priority member grievances, appeals and complaints, while clarifying issues and educating customers in the process
• Interpret and explain health plan benefits, policies, procedures and functions to members and providers
• Administer ongoing grievance tracking, trending, and reporting for assigned grievance
• Effectively manage a case load and work in a collaborative manner with your team to meet compliance timeframes.
• Demonstrate flexibility, adaptability and support change in business needs that are made to improve team performance
• Manage your time daily to ensure you are meeting and/or exceeding compliance, quality and production metrics.

About Aston Carter:

Please Note: Scammers are posing as Aston Carter. We'll never contact you via Gmail, Telegram, or WhatsApp and we'll never solicit money from you.

At Aston Carter, we’re dedicated to expanding career opportunities for the skilled professionals who power our business. Our success is driven by the talented, motivated people who join our team across a range of positions – from recruiting, sales and delivery to corporate roles. As part of our team, employees have the opportunity for long-term career success, where hard work is rewarded and the potential for growth is limitless.

Established in 1997, Aston Carter is a leading staffing and consulting firm, providing high-caliber talent and premium services to more than 7,000 companies across North America. Spanning four continents and more than 200 offices, we extend our clients’ capabilities by seeking solvers and delivering solutions to address today’s workforce challenges. For organizations looking for innovative solutions shaped by critical-thinking professionals, visit AstonCarter.com. Aston Carter is a company within Allegis Group, a global leader in talent solutions.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please call 888-237-6835 or email astoncarteraccommodation@astoncarter.com for other accommodation options. However, if you have questions about this position, please contact the Recruiter located at the bottom of the job posting. The Recruiter is the sole point of contact for questions about this position.