Job description
Position Title – Grievance and Appeals Coordinator
Address – Remote - CA
Pay – $21/hr.
Hours – 8 – 4:30 M-F PST
Vaccine Requirement – Vaccine and booster required
Position Purpose:
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.
Required Skills & Education:
- High school diploma/GED
- Facets, AUTH Accel, Microsoft Office Suite experience
- Proficient writing skills
- Able to meet or exceed deadlines
- 3+ years of Appeals and Grievance Experience
#INDTMS
Job Types: Full-time, Contract
Pay: From $21.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Health insurance
Schedule:
- 8 hour shift
- Monday to Friday
Education:
- High school or equivalent (Required)
Experience:
- Facets, Auth Accel, Microsoft Office Suite: 1 year (Required)
- Appeals and Grievance: 3 years (Required)
- Health Insurance: 1 year (Required)
- Pharmacy Services: 1 year (Preferred)
Work Location: Remote
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