Appeals and Grievance Coordinator

  • location: Houston, TX
  • type: Temporary
  • salary: $18 - $21 per hour
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job description

Appeals and Grievance Coordinator

Largest Not-For-Profit Healthcare system in Houston looking for a new team member to help in the Appeals and Grievances Department. Located in Memorial City area, this location has a fast paced environment and is fortunately located to great lunch spots as well.
This position is centered on activities related to screening of appeals concerning customer complaints, medical necessity & claims appeals, and the coordination of Grievance and Appeals.
The main responsibility of this position is to manage and coordinate the provider and enrollee grievance/appeals process as well as initiation of Independent Review Organization (IRO) external reviews process as relates to Adverse Determinations based on non-medical necessity.
Working hours: 8:00 AM - 5:00 PM
-Ability to identify problems and present plans for resolution
-Data entry and collection
-Excellent verbal and written communication skills
-Multitasking abilities
-Working well under pressure and structured deadlines
-Assertiveness and negotiation skills
-Highest degree of professionalism and work ethic
-Desire to help others
-Complying with HIPAA Regulations
Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad. EEO Employer: Race, Religion, Color, National Origin, Citizenship, Sex, Sexual Orientation, Gender Identity, Age, Disability, Ancestry, Veteran Status, Genetic Information, Service in the Uniformed Services or any other classification protected by law.
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