Our client looking for Grievance and Appeals Coordinator! Required Skills/Experience:
1.Related managed care experience
2. oral skills
3. written skills
4.Problem solving skills. 5.Analyze and resolve verbal and written claims 6.Provider complaints 7.Grievances and appeals Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members.
Responsibilities: Gather, analyze and report verbal and written member and provider complaints, grievances and appeals Prepare response letters for member and provider complaints, grievances and appeals Maintain files on individual appeals and grievances May coordinate the Grievance and Appeals Committee Support the pay-for-performance programs, including data entry, tracking, organizing, and researching information Assist with HEDIS production functions including data entry, calls to provider’s offices, and claims research. Manage large volumes of documents including copying, faxing and scanning incoming mail
- Benefits Administration
- Years of experience: 1 year
- Experience level:Experienced
Working hours: 10:30 AM - 7 PM
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