grievance and appeals coordinator .

Are you looking to use your skills in a new Grievance and Appeals Coordinator position? One of our top clients is HIRING REMOTELY in CA!  Summary: Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members. Education/Experience: High school diploma or equivalent. Associate’s degree preferred. 0-2 years of experience.  If this position interests you, apply today!   

salary: $22 - $22 per hour
shift: First
work hours: 8:30 AM - 5 PM
education: Associate

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
• Identify appeals to classify and create cases for timely assignment to other teams.  Production based area.

Skills

Grievance and Appeals Coordina

Qualifications

Years of experience: 2 years

Experience level: Experienced

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Qualified applicants in San Francisco with criminal histories will be considered for employment in accordance with the San Francisco Fair Chance Ordinance.

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