healthcare - admin and data entry.

This position is essential to compliance with regulatory requirements and individual expectations. This role serves to administer the appeals and grievance process as outlined in handbooks, departmental policies, and regulatory standards. This role is responsible for triaging and assigning all incoming appeals and grievances and will also provide administrative support to the department.

salary: $22 - $26 per hour
shift: First
work hours: 8 AM - 5 PM
education: Bachelors

Responsibilities

• Administer standard and expedited appeals processes in compliance with applicable standards and regulatory requirements, ensuring strict adherence to turnaround time standards.
• Act as the initial contact for grievances and appeals, educating individuals and gathering pertinent information.
• Identify and request necessary documentation, such as authorization or medical record release forms.
• Assign case files to appropriate department staff for management.
• Manage incoming faxes and individual-specific data, routing to the appropriate staff.
• Produce, maintain, and distribute reports/calendars for workload planning.
• Provide administrative/clerical support, including acquiring medical records and compiling appeal case files.
• Assist with the Board of Hearings (BOH) process, including packet preparation, material review, and tracking decisions.

Qualifications:

• College Degree (B.S. or B.A.) or equivalent, or two years college education (or knowledge of healthcare field equal to 2 years college preparation).
• Reliable transportation required.
• Proficiency with Microsoft Office Products, including Excel.
• Ability to work in a usual office environment with frequent sitting, walking, and standing, and use office machinery.
• Excellent oral and auditory communication skills for interpersonal communication and automated devices

Skills

Entering Data

Data Entry

Healthcare

Regulatory Compliance - Other

Problem Solving

Time Management

Medical Records

appeals

grievances

administrative support

Qualifications

Years of experience: 2 years

Experience level:

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Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact HRsupport@randstadusa.com.

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).

This posting is open for thirty (30) days.

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.