Grievance & Appeals Coordinator
Responsible for all written inquires from members seeking resolution through the grievance and appeals process. This includes investigating the issue, coordinating with internal and external contacts, present findings and monitoring compliance with employer, state, and federal regulations for Commercial and Medicare lines of business.
- Graduation from High School PLUS five years related experience OR Associates degree plus 1 year of related experience required.
- Related experience consists of customer service, member service or claims processing in an insurance enviornment. Managed care experience preferred.
- Customer service experience in managed care, insurance or healthcare environment required.
- Successful completion of Health Care Sanctions background check.
- Ability to demonstrate strong oral and written communication skills.
- Ability to work on multiple tasks.
- Skill and proficiency in the use of personal computers, especially word processing and database software.
- Highly organized and attentive to detail.
- Ability to converse and write fluently in English.