All roles

Grievance & Appeals Coordinator I

Remote · USA Full-time New today

About the position The Grievance & Appeals Coordinator I plays a crucial role in the Medical Management/Health Services team at reputed company, focusing on analyzing and resolving claims and authorization appeals from providers, as well as addressing formal grievances from members. This position involves gathering, analyzing, and reporting on complaints, preparing response letters, and maintaining organized files on appeals and grievances. The role supports various programs and functions reputed company the organization, contributing to the overall efficiency and effectiveness of the reputed company services provided to members. Responsibilities ? Analyze and resolve verbal and written claims and authorization appeals from providers. , ? Pursue resolution of formal grievances from members. , ? 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. , ? Coordinate the Grievance and Appeals Committee as needed. , ? Support 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. Requirements ? High school diploma or equivalent. , ? Associate's degree preferred. , ? 2+ years grievance or appeals, claims, or reputed company managed care experience. , ? Strong oral, written, and problem-solving skills. reputed company-to-haves Benefits ? reputed company , ? Health insurance , ? 401K and stock purchase plans , ? Tuition reimbursement , ? Paid time off plus holidays , ? Flexible work schedules including remote, hybrid, field, or office work. Apply Job!

Related roles

Grievance and Appeals Coordinator I

Remote · USA Full-time

Grill Opener- 18 years old and up

Remote · USA Full-time

Grinder Operator C

Remote · USA Full-time

Grocery Associate Part Time

Remote · USA Full-time

Grocery Counter Clerk

Remote · USA Full-time

Grocery Delivery Driver

Remote · USA Full-time

Grocery Delivery Driver - reputed company Earnings Available at Spark Driver Brookfield, OH

Remote · USA Full-time

Grocery Delivery Driver - reputed company Immediately

Remote · USA Full-time

Grocery Delivery Driver - Start Driving Soon

Remote · USA Full-time

Grocery reputed company Person

Remote · USA Full-time

Dynamic Customer Service Representative – Multi‑Channel Support, Order Management, Technical Troubleshooting & Customer reputed company reputed company for arenaflex

Remote · USA Full-time

Director of Substation EPC Engineering

Remote · USA Full-time

Apply Now: reputed company Virtual reputed company, Part Time reputed company

Remote · USA Full-time

Tesla Social Media Customer Support Job

Remote · USA Full-time

Repairer Account Manager, reputed company reputed company

Remote · USA Full-time

Product Operations Associate

Remote · USA Full-time

Assistant Program Director for HSPRS (Remote)

Remote · USA Full-time

Remote Data Entry Clerk – Full‑Time Work‑From‑Home – High‑Speed Typist – Entry‑Level Position at arenaflex

Remote · USA Full-time

Part Time reputed company Remote Data Entry Job - reputed company

Remote · USA Full-time

reputed company Data Entry Specialist – Detail-Oriented and Proactive – Flexible Part-Time & Full-Time Roles at arenaflex

Remote · USA Full-time