Position: Grievance & Appeals Coordinator
Location: Remote
Employment Type: Full-Time Contract
Pay: $33.50 per hour
Responsibilities:
- Process appeals and grievances, analyze, research, and provide comprehensive responses in accordance with established regulatory and accreditation guidelines
- Contact customers to gather information and communicate disposition of case
- Conduct pertinent research in order to evaluate, respond to, and finalize cases
- Familiar with standard concepts, practices, and procedures for analyzing, interpreting data and applying contract and regulatory provisions
Requirements:
- High School Diploma or GED required
- 2 years of customer service experience required
- Experience handling a large load of work in a fast-paced environment
- Basic computer skills
- Ability to write letters
- Insurance, Medicare/CMS knowledge
- Customer Service Experience
Preferred:
- Bachelor’s Degree in English, Communications or related field
- 2 years of health insurance experience and familiarity with health insurance state and federal regulations
- Strong project management skills
- Grievance and Appeals experience
- Experience in analyzing a claim
- Experience in classification between a grievance/appeal/organizational determination